Intravascular large B-cell lymphoma (IVLBCL) with primarily cutaneous manifestations. The image shows an intermediate-sized blood vessel filled with highly anaplastic tumor cells that were CD45+ and CD20+ (same case as the previous two images). The tumor cells are admixed with red blood cells and entrapped in fibrin. Apoptotic cells and mitotic figures are also present. The tumor cells are seen focally palisading along the vessel wall. When the disease is limited to the skin (Cutaneous variant), the prognosis is much better. The vast majority of these patients are females and younger than the rest of IVLBCL patients. Cutaneous variant makes up almost 25% of IVLBCL cases in the Western hemisphere but is quite rare in Asian patients (<5%).