Filename: B clonality.ppt case: Age related EBV associated LPD
67 yrs female with clinically indolent disease, fatigue, lymphadenopathy.
Axillary lymph node biopsy and threpine biopsy was performed. Unfortunatelly the patient was deceased soon after biopsy.
FULL HISTORY: 2007 acute pneumonia and uncertain hepatosplenomegaly. 2008 deep anemia and transfusions. Massive visceral lymphadenopathy and hepatosplenomegaly, subfebrile fever. Due to positive blood culture (Gram(-)) the patient was hospitalized (sepsis). Infiltration in the left lung, pleuritis hypoechoic nodules up to 3cm in the spleen were found. Therapy: antibiotics, duretics and transfusions. Due to dyspnea and progressing bacteriemic shock the patient was deceased. The autopsy was declined. EBV evaluation was not done.
HISTO: 1. NODE: Focal cHL picture with a reach of tumor cells areas DLBCL like.
IH: CD20+; CD30+; CD15-; EBV LMP1+; LCA+; CylinD1-; EMA-; p53+; Mum1+; Bcl6- (single +, low quality); CD10-. BM: 2 deformed nidus of fibrosis with atypical cells (HL like picture):CD20+; CD30+/-; CD15- (LOW QUALITY).
DIFFERENTIAL: CLASSIC EBV+ HOGDKIN'S LYMPHOMA (VARIANT?) vs EBV DRIVEN B LYMPHOPROLIFERATION/DLBCL.