Epstein-Barr Virus-Positive CD20- and CD45-Negative Diffuse Large B-Cell Lymphoma: A Diagnostic Challenge.

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Citation: International Journal of Surgical Pathology. 27(1):98-101, 2019 Feb.PMID: 29968492Institution: MedStar Washington Hospital CenterDepartment: PathologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Biomarkers, Tumor/an [Analysis] | *Lymphoma, Large B-Cell, Diffuse/di [Diagnosis] | Adult | Antigens, CD20/an [Analysis] | Epstein-Barr Virus Infections/co [Complications] | Herpesvirus 4, Human | Humans | Leukocyte Common Antigens/an [Analysis] | Lymphoma, Large B-Cell, Diffuse/vi [Virology] | MaleYear: 2019ISSN:
  • 1066-8969
Name of journal: International journal of surgical pathologyAbstract: Diffuse large B-cell lymphoma (DLBCL) is characterized by medium- to large-sized neoplastic cells that express a wide range of B-cell markers including CD19, CD20, CD22, and CD79a. Also, as this is a hematopoietic malignancy, there is expression of the leukocyte common antigen CD45. Lack of CD20 expression occurs in a specific rare heterogeneous subgroup of DLBCL including primary effusion lymphoma, plasmablastic lymphoma, ALK-positive large B-cell lymphoma, and large B-cell lymphoma arising in HHV8+ multicentric Castleman disease. In this article, we report a rare case of CD20- and CD45-negative Epstein-Barr virus-positive DLBCL in which the entities listed above were ruled out, thereby posing a significant diagnostic challenge. Arriving at the correct diagnosis of Epstein-Barr virus-positive DLBCL was supported by immunoreactivity for the B-cell transcription factor Oct-2 and the pan-B cell marker CD79a.All authors: Kallakury B, Kwon DH, Starr AFiscal year: FY2019Fiscal year of original publication: FY2018Digital Object Identifier: ORCID: Date added to catalog: 2018-07-30
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Journal Article MedStar Authors Catalog Article 29968492 Available 29968492

Diffuse large B-cell lymphoma (DLBCL) is characterized by medium- to large-sized neoplastic cells that express a wide range of B-cell markers including CD19, CD20, CD22, and CD79a. Also, as this is a hematopoietic malignancy, there is expression of the leukocyte common antigen CD45. Lack of CD20 expression occurs in a specific rare heterogeneous subgroup of DLBCL including primary effusion lymphoma, plasmablastic lymphoma, ALK-positive large B-cell lymphoma, and large B-cell lymphoma arising in HHV8+ multicentric Castleman disease. In this article, we report a rare case of CD20- and CD45-negative Epstein-Barr virus-positive DLBCL in which the entities listed above were ruled out, thereby posing a significant diagnostic challenge. Arriving at the correct diagnosis of Epstein-Barr virus-positive DLBCL was supported by immunoreactivity for the B-cell transcription factor Oct-2 and the pan-B cell marker CD79a.

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