Blood Res 2015; 50(4): 192  https://doi.org/10.5045/br.2015.50.4.192
A T-cell/histiocyte-rich large B-cell lymphoma involving only the bone marrow
Maria Shafiq, and Farheen Karim*

Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan.

Correspondence to: Correspondence to Farheen Karim, M.D. Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan. farheen.mahar@aku.edu
Published online: December 21, 2015.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

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We examined the bone marrow biopsy of a 19-year-old male patient who had a fever for 3 months. Physical examination findings were unremarkable; blood culture results were negative. Computed tomography of the neck, chest, abdomen, and pelvis did not reveal lymphadenopathy or any other abnormality. His peripheral blood examination revealed a hemoglobin level, 9.7 g/dL; white blood cell count, 2.6×109/L; and platelet count, 32×109/L. The peripheral blood film showed a leukoerythroblastic picture. The bone marrow aspirate resulted in a dry tap. Bone trephine was a specimen of adequate length. The normal architecture was completely effaced. There was diffuse infiltration with pleomorphic lymphoid cells (A, B). Some cells were large; these atypically large cells showed positivity for CD20 (C) and negativity for CD15 and CD30. The small lymphocytes in the background showed positivity for CD3 (D). A diagnosis of T cell/histiocyte-rich large B-cell lymphoma was made. T cell/histiocyte-rich large B-cell lymphomas are a rare and aggressive subtype of diffuse large B-cell lymphoma. The neoplastic B cells constitute <10% of cells of the infiltrate. Primary involvement of the bone marrow in this type of lymphoma, observed in this case, is a very rare finding.



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