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| ==Biopsy== | | ==Biopsy== |
| Biopsy is diagnostic of large B cell lymphoma. | | Biopsy is diagnostic of large B cell lymphoma. |
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| ==Microscopic Pathology==
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| | [[Image:215px-diffuse large B cell lymphoma - cytology low mag.jpg|thumb|350px|Micrograph of a diffuse large B cell lymphoma]]
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| * Three variants are most commonly seen: centroblastic, immunoblastic, and anaplastic.
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| ===Centroblastic===
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| * Most cases of are diffuse large B cell lymphoma centroblastic, having the appearance of medium-to-large-sized [[lymphocyte]]s with scanty [[cytoplasm]].
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| * Oval or round [[Cell nucleus|nuclei]] containing fine [[chromatin]] are prominently visible, having two to four [[nucleoli]] within each nucleus.
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| * Sometimes the tumour may be monomorphic, composed almost entirely of centroblasts.
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| * However, most cases are polymorphic, with a mixture of centroblastic and immunoblastic cells.
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| ===Immunoblastic===
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| * Immunoblasts have significant [[basophilic]] cytoplasm and a central nucleolus.
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| * A tumour can be classified as immunoblastic if greater than 90% of its cells are immunoblasts. This distinction can be problematic, however, because hematopathologists reviewing the microscope slides may often disagree on whether a collection of cells is best characterized as centroblasts or immunoblasts.<ref name="Harris1994">{{cite journal |pmid=8068936 |year=1994 |last1=Harris |first1=N. L. |title=A revised European-American classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group |journal=Blood |volume=84 |issue=5 |pages=1361–92 |last2=Jaffe |first2=E. S. |last3=Stein |first3=H |last4=Banks |first4=P. M. |last5=Chan |first5=J. K. |last6=Cleary |first6=M. L. |last7=Delsol |first7=G |last8=De Wolf-Peeters |first8=C |last9=Falini |first9=B |last10=Gatter |first10=K. C. |url=http://www.bloodjournal.org/content/84/5/1361 }}</ref> Such disagreement indicates poor [[inter-rater reliability]].
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| ===Anaplastic===
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| * The third morphologic variant, [[Anaplasia|anaplastic]], consists of tumour cells which appear very differently from their normal B cell counterparts.
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| * The cells are generally very large with a round, oval, or polygonal shape and pleomorphic nuclei, and may resemble [[Hodgkin's lymphoma#Pathology|Hodgkin cells]] or reed–Sternberg cell.
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| ==References== | | ==References== |