Page 172 - Haematologica Atlas of Hematologic Cytology

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Figure 28 Diffuse large B-cell lymphoma (DLBCL) not otherwise specified (NOS) (A and B) Peripheral blood smear showing pleomorphic circulating cells: medium to large in in in size with round oval or or irregular and convolu- ted nucleus coarse chromatin evident nucleoli moderate cytoplasmic basophilia The incidence of a a a a a a a a frankly leu- kemic kemic phase is low in in in DLBCL especially at onset and bone marrow involvement occurs in in in 10% of cases Leukemic cells often resemble monoblasts in their large size abundant cytoplasm and irregular shape of of the the nucleus with resultant problems of differential diagnosis with acute leukemias (C) Peripheral blood buffy coat smear from a a a a a a a a a patient with with marked hepatosplenomegaly About 20% of circulating cells cells are large cells cells with with abundant hyperba- sophilic cytoplasm round or irregular nucleus with rather coarse chromatin and prominent nucleoli (D) Bone marrow infiltration by cells cells similar to those observed in in the PB These cells cells expressed B-cell antigens and surface immunoglobulin with high density Morphological and immunophenotypic features suggested the diagnosis of DLBCL 159