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Anaplastic tumor with plasmoid features (2140) » Hypocellular 1.jpg
Filename: Hypocellular 1.jpg
[Anaplastic tumor with plasmoid features]
68 yrs old female with clinical diagnosis DLBCL (after chemotherapy). Threpine biopsy.  
HISTO: BM with cellularity to 80% and 70% focal and diffuse interstitial infiltrates consising of small- medium basophilic cells with oval slightly eccentric nuclei. Focal I° reticular fibrosis. Some large histyocytic cells in hypocellular areas with eosinophilic coarse granules in cytoplasm.  
IH: CD138+ single plasmacytes (normal)(<5%).  
TUMOR: CD138(-), CD20(+++) 100%, CD79a 50% (++), CD56/CD23/Bcl 6/Bcl 2(-), Mum1 (+/++) 30%, CD3(-)(except T lympho's), CD10(-), Ig kappa (+++) 50%, Ig lambda (-).  
CD68 reaction on large eosinophilic cells is uninformative (hypocellular areas disappear in serial sections).  
WORKING DIAGNOSIS: High grade lymphoma: anaplastic myeloma CD138 (-) vs DLBCL with crystaline hystiocytosis.  
QUESTION: Histological criteria for discrimination of anaplastic "plasmoid" (by HE or IH) lessions.  
Cytollogical quality is SUBOPTIMAL. A lot of appologies.  
PRIMARY PULMONARY? TUMOR (2004 consultation case with clin. dgn. "Central tumor in upper pulmonary lobe"): The moderatelly cellular "clear" (T lymhoma like) infiltrate of the atypical medium- large CLEAR and EOSINOPHILIC cells with high proliferative rate and CB like cytology. The necrosis and vascularity are promiment. Single giant cells with nuclear lobulations.  
IH PRIMARY: CD20+, CD30-, CD3-. PanCK-, CD99- (In 2004 IH panel was more narrow than nowadays).  
NOTE: Old parafinn blocks are not avalable now.  
Thank you for collaboration.
Sender: ugnius
2006-08-09 12:30
INCTR - EBMWG Hematopathology Online

Last modified: 2006-08-09 12:30:00