63 yrs old Lady with 2005 diagnosed DLBCL (clin. diagnosis was MDS with transformation to AML). After-8 CHOP- treatment 2007 threpine biopsy was done due to hemolysis (progression?): Hb 42g/l; Coombs +; hyperbilirubinemia; Under the Prednisone therapy now.  
SHORT CLIN HISTORY: 2005 10 18: Weakness, dizziness, sweets. Flow: BM lymphocytosis (DLBCL or B marginal zone immunophenotype). Slight hepatomegaly. Blood lymphocytosis 67%. Anemia, thrombocytopenia.  
2006 01 31: subclinical compression fractures of Th8/Th11/Th12.  
2007 06 18: there are any LN, spleen, liver enlargement. Blood: lymphocytosis 40%. BM: lymphocytosis 92.5%.  
HISTO: There is diffuse infiltrate of small, cc like cells with admixture of "blastoid" ones with rudimentary? large cell formed follicle center.  
IH: tumor population: CD20(+++) 100%, CD3/CD5/CD43(-), Bcl2(++/+++) 90%, Bcl6(-) 10% (except FC), CD10/Mum1/CyclinD1/CD30(-), Ig kappa/lambda (-/polytipic), CD23(-)(except large fdc nodule in fc), IgM (+/+++) 100% , IgD(+) 10%. Ki67 ~5% (In FC higher: up to 80% (+++). Prominent intyersticial CD57+ T lympho's. CD21+ FDC network in the LARGE FC and in the INFILTRATED? smaller not vissble in HE follicles. CD138+ polytypic intersticial plasmacytes ~5%.  
 
NOTE: OLD biopsy with darker and clear areas maybe in part due to processing/fixation deficiencies.  
 
PROPOSED DIAGNOSIS: B low grade lymphoma: B marginal zone lymphoma vs FL with extensive marginal differenciation. RETROSPECTIVE (Photo: OLD) biopsy: the same changes.  
 
Thank you for participating and understanding. Appologies, if photos do not represent the same fields or do not represent the definite problem properly.