title: Primary bone marrow T-cell/histiocyte-rich large B-cell lymphoma: a diagnostic challenge.
abstract: We report a primary bone marrow diffuse large B-cell lymphoma in a 52-year-old post-menopausal woman that evaded definitive diagnosis initially due to deceptive clinical features, non-contributory radiological findings, and an extensive reactive lymphoid infiltrate masking the relatively few neoplastic B-cells on bone marrow biopsy. The correct diagnosis was apparent only after a repeat bone marrow procedure and review of the previous histology and immunohistochemistry. The case illustrates the pitfall of assuming mixed B- and T-cell infiltrates in the bone marrow to be invariably benign. A high index of suspicion regardless of the clinical and/or radiological absence of lymphadenopathy or organomegaly and critical examination of each individual cell population in immunohistochemically stained material are essential for correct identification of this rare entity.
authors.affiliation: Department of Haematology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Sharma
authors.forename: Jasmina
authors.initials: J
authors.lastname: Ahluwalia
authors.forename: Man Updesh Singh
authors.initials: MU
authors.lastname: Sachdeva
authors.forename: Neelam
authors.initials: N
authors.lastname: Varma
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
mesh_terms: D018951:Antigens, CD20 / Q000378:metabolism; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology; D001854:Bone Marrow Cells / Q000473:pathology*; D017252:CD3 Complex / Q000378:metabolism; D051925:CD79 Antigens / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006644:Histiocytes / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000378:metabolism; D008875:Middle Aged; D013601:T-Lymphocytes / Q000378:metabolism / Q000473:pathology*
chemical_list: D018951:Antigens, CD20; D017252:CD3 Complex; D051925:CD79 Antigens