Microscopic Description -- Left Neck Mass


The lymph nodes are partially effaced by a proliferation of monotonous, medium-sized, lymphoid cells having finely granular chromatin, 1 to 4 small, irregular, amphophilic nucleoli and a small rim of cytoplasm. There is a high turnover rate with focal necrosis, numerous mitotic figures and cellular debris-laden macrophages. The proliferating cells are CD20 (L26;B-cell) positive and most stain with the EBER probe. The cells appear to stain for lambda light chain. Several EBV-BZLF1 positive cells are seen; most appear to be small, non-transformed lymphocytes. There is capsular scarring and extension of the neoplastic cells into the extranodal tissue. The non-effaced portions have sinus histiocytosis and marked follicular hyperplasia with focal follicular necrosis. Neutrophils are present in one germinal center.

Final Diagnosis


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