73 yrs. male with history of actinic therapy for prostatic carcinoma and TUR for urothelial carcinoma. Nowadays: general malaise, febrility 39C°, visceral lymphadenopathy and hepatosplenomegaly. Inguinal small node biopsy was performed.  
HISTO: Vaguelly nodular medium- large cell infiltrate in the cortical zone with admixture of T cells and CD21/CD23 FDC hyperplastic networks; Medullary zone: AILT like picture with small- medium T lympho's, HEV's and slightly irregular nuclei.  
IH: large B cells, vaguelly nodular: CD20+ Mum1+ > Bcl6+ Bcl2+ (patchy) LMO2+ (!) Ki67 about 70%. Large amount CD30+ RS like cells.  
T zone: usual T phenotype: CD3+ CD4+ > CD8+, but FAINT Bcl2!  
MOLEC's: IgH/K clone. TCR polyclonal.  
 
PROPOSAL: Visually seems like FL grade 3, but neoplastic cells (mainly immunoblasts) scant enough with reminescent of GCB IH...  
So version is: DLBCL (nodular), maybe evolving from AILT (or T LPD with secondary DLBCL) (?). I presumed EBV (age asociated LPD/ DLBCL etc.), but EBV LMP1/EBER completelly negative.

tzankov 2012-10-16 06:57	I have the feeling that I have already seen the case in the hempath group. I would classify it as DLBCL with a peculiar nodular grwoth pattern, an evolvement form AITL is a good idea, but there are no criteria within the biopsy to diagnose it with certainity.
ugnius 2012-10-29 14:54	Thanx. Really I just create new case there and import to HEMATO- its appears completed at once.