Ann Lab Med.  2017 Nov;37(6):544-546. 10.3343/alm.2017.37.6.544.

A Case of Primary Bone Marrow Diffuse Large B-cell Lymphoma Presenting With Fibrillar Projections and Hemophagocytic Lymphohistiocytosis

• Kim MS
• Cho YU
• Jang S
• Seo EJ
• Lee JH
• Park CJ

• KMID: 2425999
• DOI: http://doi.org/10.3343/alm.2017.37.6.544

Abstract

No abstract available.

MeSH Terms

B-Lymphocytes*
Bone Marrow*
Lymphohistiocytosis, Hemophagocytic*
Lymphoma, B-Cell*

Figure

• 

  Fig. 1 Cyto- and histomorphology of bone marrow. (A) Bone marrow aspirate smear demonstrates clusters of neoplastic cells with fibrillar projections (red arrow). A histiocyte that has engulfed neutrophils and lymphocytes (green arrow) is also seen (Wright-Giemsa stain, ×1,000). (B) Bone marrow trephine biopsy specimen shows nodular infiltrates of neoplastic cells. No evidence of destruction of trabecular bone is seen (Hematoxylin & Eosin stain, ×200). A few neoplastic cells appear in a pattern of intrasinusoidal infiltration (right lower inset; immunostaining for CD34, ×400).

• 

  Fig. 2 Immunophenotyping and immunoglobulin heavy chain gene (IGH) clonality of the neoplastic cells. Neoplastic cells were positive for CD20 (A), CD5 (B), BCL6 (C), and IRF4/MUM1 (D) by immunostaining (×200). (E) The proliferative fraction of neoplastic cells as detected by Ki67 immunostaining was 90% (×200). (F) Neoplastic cells were positive for a clonal IGH rearrangement, which was consistent with the presence of a clonal B-cell population (IdentiClone IGH Gene Clonality Assay, Invivoscribe Technologies, Inc., San Diego, CA, USA).

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