Bone
Hematologic neoplasms
Diffuse large B cell lymphoma (DLBCL)

Author: Sheren Younes, M.D. (see Authors page)

Revised: 4 November 2016, last major update May 2014

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: diffuse large B cell lymphoma [title] bone

Cite this page: Diffuse large B cell lymphoma (DLBCL). PathologyOutlines.com website. http://pathologyoutlines.com/topic/bonediffuselargecell.html. Accessed June 28th, 2017.
Definition / general
  • Most common type of lymphoma occurring in bone
  • To be considered a primary bone tumor, must have no evidence of disease elsewhere for 6 months
Sites
  • Long bones, axial skeleton, limb girdles
Clinical features
Radiology description
  • Large area of bone destruction and production, resembling osteomyelitis
Radiology images
Images hosted on PathOut server:

Distal femur xray, by Dr. Mark R. Wick

Shoulder xray, by Dr. Mark R. Wick

Case reports
Clinical images
Images hosted on PathOut server:

Large cell lymphoma, skin and foot, by Dr. Mark R. Wick

Gross description
  • Pinkish gray tumor in diaphysis or metaphysis of long bone, with patchy cortical and medullary destruction
  • Often soft tissue extension; variable periosteal reaction
Microscopic (histologic) description
  • Similar to morphology at other sites: diffuse growth pattern, infiltrating between bone trabeculae
  • Large atypical cells with abundant cytoplasm
  • Centroblasts, immunoblasts, or large bizarre cells
  • Nuclei show clumped chromatin, prominent nucleoli
  • Component of small lymphocytes is admixed with large cells
  • May have marked spindling and fibrosis
Microscopic (histologic) images
Images hosted on PathOut server:

Immunoblastic large cell, CD79a, by Dr. Mark R. Wick

Large cell lymphoma, skin and foot, by Dr. Mark R. Wick


By Dr. Mark R. Wick



Images hosted on other servers:

Various images and stains

Technetium bone scan, H&E, CD20

H&E

H&E, BCL6, BCL2, p53

Cytology description
  • Variable combination of centroblasts, immunoblasts
  • May show large bizarre cells
Peripheral smear description
  • Lymphoma cells are rarely present in peripheral blood; when centroblasts are present, cells are very large and pleomorphic with abundant cytoplasm, often lobulated nucleus containing one or more fairly prominent nucleoli
Positive stains
Negative stains
Flow cytometry description
  • Shows clonal rearrangement, helps determine phenotype
Electron microscopy description
  • Centroblasts have cleaved nuclei, immunoblasts have large round nuclei with coarse chromatin and 1 - 3 prominent nucleoli
  • Rough endoplasmic reticulum with dilated cisternae and prominent Golgi apparatus are also apparent
  • The degree to which these features are present reflects the cellular degree of plasmacytoid differentiation
Molecular / cytogenetics images
Images hosted on other servers:

FISH-MYC gene

Differential diagnosis