EBV+ DLBCL, NOS : Differential

Comments:
EBV+ Diffuse Large B-cell Lymphoma (DLBCL), NOS: Low magnification view of polymorphic subtype showing a population of large atypical lymphoid cells scattered in a background of small lymphocytes, epithelioid histiocytes, plasma cells, and a few eosinophils.

The differential diagnosis for polymorphic subtype includes T-cell/histiocyte-rich large B-cell lymphoma and Hodgkin lymphoma. In elderly patients, the features favoring EBV+ DLBCL, NOS over Hodgkin lymphoma are: extranodal presentation, frequent necrosis, strong immunoreactivity for B-lineage markers, and negativity for CD15. This distinction is more challenging in younger patients who frequently present with nodal disease.