DLBCL – Anaplastic Variant

The anaplastic variant of diffuse large B-cell lymphoma (DLBCL) is a morphologic variant under the DLBCL, NOS category in the WHO Classification. Typical common features include:

Marked nuclear pleomorphism, often confused with poorly differentiated carcinoma.
Large and significantly enlarged neoplastic cells.
May resemble Hodgkin lymphoma or anaplastic large cell lymphoma (ALCL).

Should not be confused with anaplastic large cell lymphoma (ALCL), which is a T-cell neoplasm.

Common Findings

More aggressive course with poor outcome
p53 expression (80%)
CD30 expression (51%)
Double expressor (43%), both MYC and bcl-2 IHC expression
MYC and BCL-2 and/or BCL-6 abnormalities (translocation or extra copies)

Photomicrographs

DLBCL Anaplastic Variant with marked nuclear pleomorphism.

DLBCL Anaplastic Variant - CD45 — DLBCL Anaplastic Variant – CD45

DLBCL Anaplastic Variant - CD20 — DLBCL Anaplastic Variant – CD20

DLBCL Anaplastic CD10 — CD10 expression in a case of anaplastic DLBCL.

References

Swerdlow SH, Campo E, Harris, NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds): WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). IARC: Lyon 2017

Li M, Liu Y, Wang Y, Chen G, Chen Q, Xiao H, et al. Anaplastic Variant of Diffuse Large B-cell Lymphoma Displays Intricate Genetic Alterations and Distinct Biological Features. Am J Surg Pathol. 2017;41: 1322–1332. doi:10.1097/PAS.0000000000000836