T-CELL-RICH B-CELL-LYMPHOMA - DIAGNOSIS, DIFFERENTIAL-DIAGNOSIS, AND CLASSIFICATION IN 2 EXEMPLARY CASES

Two post mortem examinations from the Institute of Pathology, Albert-L udwigs-University of Freiburg, will be presented. In both cases diagno sis of a T-cell-rich B-cell-lymphoma was first established after necro psy and evaluation of the immunohistochemical results. In the first ca se a peripheral T-cell-lymphoma was diagnosed after a peripheral T-cel l-marker test. A liver biopsy showed suspicion of a Hodgkin-lymphoma. In the second case a biopsy of an extended retroperitoneal tumor showe d a centroblastic non-Hodgkin-lymphoma 3 weeks before death. By autops y we found in both cases a wide infiltration with small monomorphic ly mphocytes. Less than 20% of the infiltrate consisted of polymorphous b lasts with a wide morphologic range and prominent nucleoli. Immunohist ochemistry showed the blasts to be CD20-positive, while the small mono morphic lymphocytes expressed the CD3 marker. In the first case kappa- light-chain-restriction was shown in the blasts by immunohistochemistr y. Differential diagnosis difficulties, diagnostic criteria, prognosis and classification of these cases in the common non-Hodgkin-lymphoma classification will be discussed in view of the current literature.