Table 2 Differential diagnostic... | American Society of Hematology

Table 2

Differential diagnostic considerations of EBV-positive DLBCL of the elderly

Entity	Site	Architecture	Immunophenotype	Specific findings	Light chain	Clonality
EBV-positive DLBCL, elderly	N (70%)	Effaced	Pan B markers⁺	Geographic necrosis	Monotypic	Monoclonal
EBV-positive DLBCL, elderly	E (30%)	Effaced	CD10⁻/BCL6⁻/MUM1⁺, EBER⁺,CD30^+/−	Geographic necrosis	Monotypic	Monoclonal
EBV-associated reactive atypical lymphoproliferations/infectious mononucleosis in elderly	N	Not effaced	Mixed B- and T-cell nature of HRS-like cells (CD3⁺/20⁺/30⁺)	n/a	Polytypic	Polyclonal
	N	Not effaced	EBER⁺	n/a	Polytypic	Polyclonal
EBV-positive classical Hodgkin lymphoma	N	Effaced	CD20^-/CD79a^-/Pax5^w+	HRS cells in reactive background	Polytypic	Polyclonal
EBV-positive classical Hodgkin lymphoma	N	Effaced	CD30⁺/CD15⁺, EBER^+/−	HRS cells in reactive background	Polytypic	Polyclonal
DLBCL, NOS, anaplastic variant	N	Effaced	Pan B markers⁺	Sinusodal or cohesive pattern	Monotypic	Monoclonal
DLBCL, NOS, anaplastic variant	N	Effaced	EBER^-, CD30⁺	Sinusodal or cohesive pattern	Monotypic	Monoclonal
T-cell/histiocyte-rich large B-cell lymphoma	N	Effaced	Pan B markers⁺	Scattered B cells in benign T cells/histiocytes background	Monotypic	Monoclonal
T-cell/histiocyte-rich large B-cell lymphoma	N	Effaced	EBER⁻, CD30^+/−, CD15^-	Scattered B cells in benign T cells/histiocytes background	Monotypic	Monoclonal
Primary cutaneous DLBCL, leg type	E (skin)	Dermal infiltration	Pan B-cell markers⁺, EBER^-	Diffuse sheets of centroblasts and immunoblasts	Monotypic	Monoclonal
Primary cutaneous DLBCL, leg type	E (skin)	Dermal infiltration	BCL2⁺/MUM1⁺/FOXP1⁺	Diffuse sheets of centroblasts and immunoblasts	Monotypic	Monoclonal
Lymphomatoid granulomatosis	E	polymorphic infiltration	EBER⁺, LMP1⁻	Angioinvasion, HRS-like cells in reactive background	Noninformative	Monoclonal
Plasmablastic lymphoma of the elderly	N (50%)	Effaced	CD38⁺, CD138⁺, MUM1⁺, CD20⁻	Plasmablastic morphology	Monotypic	n/a
Plasmablastic lymphoma of the elderly	E (50%)	Effaced	EBER⁺, LMP1⁻, EBNA2^-	EBV latency I	Monotypic	n/a
Angioimmunoblastic T-cell lymphoma	N	Effaced	CD10⁺, CXCL13⁺, PD1⁺	FDC expansion	Polytypic	Monoclonal in T cells
Peripheral T-cell lymphoma, not otherwise specified	N	Effaced	CD3^+/− with partial loss of T-markers, CD30^+/−, CD15^−/+	Large atypical cells	Polytypic	Monoclonal in T cells
Peripheral T-cell lymphoma, not otherwise specified	N	Effaced	EBER^−/+	Clear cytoplasm^+/−	Polytypic	Monoclonal in T cells

Entity	Site	Architecture	Immunophenotype	Specific findings	Light chain	Clonality
EBV-positive DLBCL, elderly	N (70%)	Effaced	Pan B markers⁺	Geographic necrosis	Monotypic	Monoclonal
EBV-positive DLBCL, elderly	E (30%)	Effaced	CD10⁻/BCL6⁻/MUM1⁺, EBER⁺,CD30^+/−	Geographic necrosis	Monotypic	Monoclonal
EBV-associated reactive atypical lymphoproliferations/infectious mononucleosis in elderly	N	Not effaced	Mixed B- and T-cell nature of HRS-like cells (CD3⁺/20⁺/30⁺)	n/a	Polytypic	Polyclonal
	N	Not effaced	EBER⁺	n/a	Polytypic	Polyclonal
EBV-positive classical Hodgkin lymphoma	N	Effaced	CD20^-/CD79a^-/Pax5^w+	HRS cells in reactive background	Polytypic	Polyclonal
EBV-positive classical Hodgkin lymphoma	N	Effaced	CD30⁺/CD15⁺, EBER^+/−	HRS cells in reactive background	Polytypic	Polyclonal
DLBCL, NOS, anaplastic variant	N	Effaced	Pan B markers⁺	Sinusodal or cohesive pattern	Monotypic	Monoclonal
DLBCL, NOS, anaplastic variant	N	Effaced	EBER^-, CD30⁺	Sinusodal or cohesive pattern	Monotypic	Monoclonal
T-cell/histiocyte-rich large B-cell lymphoma	N	Effaced	Pan B markers⁺	Scattered B cells in benign T cells/histiocytes background	Monotypic	Monoclonal
T-cell/histiocyte-rich large B-cell lymphoma	N	Effaced	EBER⁻, CD30^+/−, CD15^-	Scattered B cells in benign T cells/histiocytes background	Monotypic	Monoclonal
Primary cutaneous DLBCL, leg type	E (skin)	Dermal infiltration	Pan B-cell markers⁺, EBER^-	Diffuse sheets of centroblasts and immunoblasts	Monotypic	Monoclonal
Primary cutaneous DLBCL, leg type	E (skin)	Dermal infiltration	BCL2⁺/MUM1⁺/FOXP1⁺	Diffuse sheets of centroblasts and immunoblasts	Monotypic	Monoclonal
Lymphomatoid granulomatosis	E	polymorphic infiltration	EBER⁺, LMP1⁻	Angioinvasion, HRS-like cells in reactive background	Noninformative	Monoclonal
Plasmablastic lymphoma of the elderly	N (50%)	Effaced	CD38⁺, CD138⁺, MUM1⁺, CD20⁻	Plasmablastic morphology	Monotypic	n/a
Plasmablastic lymphoma of the elderly	E (50%)	Effaced	EBER⁺, LMP1⁻, EBNA2^-	EBV latency I	Monotypic	n/a
Angioimmunoblastic T-cell lymphoma	N	Effaced	CD10⁺, CXCL13⁺, PD1⁺	FDC expansion	Polytypic	Monoclonal in T cells
Peripheral T-cell lymphoma, not otherwise specified	N	Effaced	CD3^+/− with partial loss of T-markers, CD30^+/−, CD15^−/+	Large atypical cells	Polytypic	Monoclonal in T cells
Peripheral T-cell lymphoma, not otherwise specified	N	Effaced	EBER^−/+	Clear cytoplasm^+/−	Polytypic	Monoclonal in T cells

n/a, not available; FDC, follicular dendritic cell meshworks; Pan B-cell markers, CD19, CD20, CD22; Site E, extranodal; Site N, nodal.^{1,25,42-44,46,82,84-88}