STORY: 76 yrs female. After threpine biopsy (polymorphic clonal lymphoid hyperplasia) splenectomy was performed. ~4 yrs progressing splenomegaly. Sweats, weight loss, elevated LDH 560u/l.  
HISTO:  
Spleen: Nodular and focal diffuse, pleomorphic B infiltrate with focal concenantration of "blasts" with fibrosis and macrophageal admixture.  
Threpine: Slightly irregular follicles with normal architecture and scattered perilipocytic B aggregates.  
IH (spleen): CD20+; CD10(-); Bcl6+; MUM1+; Bcl2+; cMYC(-); IgM/IgD+; Cyclin D1(-); EBER(-).  
MOLECS:  
Threpine: B clonal (not the same clone, as in the spleen).  
Spleen: B clonal (different clone).  
VIRTUAL SLIDES: Aperio.  
 
PROPOSAL: 1. Splenic DLBCL (nodular/micronodular, enreached with Ma/T cells, with sclerosis), transformed from SMZL. 2. Clonal B lymphoid hyperplasia in BM, compatible with SMZL spread (?). 3. The different clones: a. Pseudoclonality in BM??? b. Different DLBCL clone expansion???