Which histologic findings are characteristic of large cell lymphoma

Updated: Jun 14, 2018
  • Author: J Martin Johnston, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

LCLs are a heterogeneous group, with LCL in most cases being classified as the B- or T-cell type. The B-cell–derived LCLs histologically merge with the SNCCLs. In terms of the expression of cell-surface proteins, these tumors are currently indistinguishable. If infiltrating macrophages are present, these cells can serve as a reference by which the tumor cells are measured. In B-cell LCLs, many or most of the tumoral nuclei are larger than those of the macrophages. B-cell LCLs can be divided into germinal center and nongerminal center subtypes, a distinction that carries prognostic significance in adult patients; in pediatric patients, germinal-center type B-LCLs predominate, which explains, in part, the overall better outcomes for pediatric patients (versus adults) with B-cell LCL. [56]

Anaplastic LCLs are more common than B-cell LCLs and are derived from T cells, as evidenced by their TCR gene rearrangements. However, anaplastic LCLs may express few T-cell surface markers. Their hallmark is the expression of CD30, or Ki-1, an antigen first recognized on Hodgkin lymphoma cells. Aberrant expression of myeloid markers CD13 and CD33 has more recently been reported as a sensitive (but not specific) marker of ALK+ anaplastic LCL. [57]

Other cell surface markers that may be observed are HLA-DR and the IL-2 receptor. Finally, a small number of LCLs do not exhibit a clear T-cell or B-cell phenotype. At least some of these tumors are of histiocytic origin.


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