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Intravascular large B cell lymphoma presenting in a liver explant
  1. M Roshal1,
  2. B G Till2,
  3. J R Fromm1,
  4. S Cherian1
  1. 1
    Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
  2. 2
    Clinical Research Division, Fred Hutchinson Cancer Research Center and Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA, USA
  1. Dr S Cherian, University of Washington, Department of Laboratory Medicine, Box 357110, 1959 NE Pacific Street, NW120 Seattle, WA 98195-7110, USA; cherians{at}u.washington.edu

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A 51-year-old man with end stage liver disease secondary to hepatitis C underwent liver transplantation. The explanted liver showed cirrhosis and hepatitis. Additionally, the small hilar vessels were filled with large atypical lymphocytes with scant cytoplasm, irregular nuclei, dispersed chromatin and prominent nucleoli (fig 1). The neoplastic cells expressed CD45, CD20, PAX-5 and MUM1 without CD5, CD10 or BCL-6 by immunohistochemistry. A diagnosis of intravascular large B cell lymphoma (IVLBCL) was made.

Figure 1 (A, B) H&E stained sections of the liver hilum at low (150×) and high (945×) power. (C) CD20 stain.

Staging studies (body CT scan, bone marrow biopsy, peripheral blood flow cytometry, skin survey, and brain MRI) were negative. The patient was asymptomatic and initially followed by observation. A PET scan …

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