title: Multilobated large B-cell lymphoma diagnosed cytologically. A case report.
abstract: BACKGROUND
  Fine needle aspiration (FNA) biopsy can be used to reliably classify most conditions involving lymph nodes or, at least, significantly reduce the differential diagnosis.
  
  
  METHODS
  A 70-year-old male presented with an ulcerated mass arising from the left tonsillar fossa and involving the anterior and posterior pillars. A biopsy of the tonsillar mass performed at an outside hospital was interpreted as a large cell undifferentiated carcinoma. Subsequently the patient developed systemic lymphadenopathy. A bone scan showed intense uptake within the medial tibial plateau of the left knee. FNA biopsy of the right axillary mass was interpreted at University of Cincinnati Medical College as a large cell lymphoma, multilobated type. Histologic and immunohistochemical studies of the lymph node confirmed the presence of multilobated B-cell lymphoma. Lymphoma chemotherapy was initially successful but was discontinued due to toxicity. The patient died two months after the initial cytologic diagnosis of lymphoma.
  
  
  CONCLUSIONS
  Multilobated lymphomas are an unusual variant of non-Hodgkin's lymphomas (mostly B-cell type). Cytology and immunocytochemistry are useful diagnostic procedures that can help to diagnose this relatively uncommon type of lymphoma and significantly reduce the possibility of misdiagnosis.
authors.affiliation: Department of Pathology, University of Cincinnati Medical College, Ohio 45267-0529, USA.
authors.forename: I
authors.initials: I
authors.lastname: Sheyn
authors.forename: J
authors.initials: J
authors.lastname: Mira
authors.forename: R
authors.initials: R
authors.lastname: Yassin
authors.forename: P
authors.initials: P
authors.lastname: Steele
authors.forename: D
authors.initials: D
authors.lastname: Roychowdhury
authors.forename: R
authors.initials: R
authors.lastname: Blanco
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D009367:Neoplasm Staging; D014066:Palatine Tonsil / Q000473:pathology; D015203:Reproducibility of Results; D014067:Tonsillar Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000532:radiotherapy