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Testis : CLL & DLBCL

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Large B-cell Lymphoma of the Testis in a background of CLL/SLL (same case as the previous gross specimen photograph): The image shows sheets of uniform small to medium-sized mature lymphocytes in the interstitium. They have scant cytoplasm, slightly irregular nuclear contours, condensed chromatin, inconspicuous nucleoli, and absent mitotic activity. An atrophic seminiferous tubules is present in the center.

Flow Cytometry: Two populations of kappa light chain-restricted B-cells were found. About 80% of B-cells had immunophenotype compatible with CLL/SLL (CD19+, CD20 dim+, CD5+, CD23 variable+, and kappa dim+). The remain 20% of B-cells were intermediate-to-large size with the following profile: CD19+, CD20 mod+, CD5-, CD23-, CD10+, and kappa mod+. CD38 was positive in 30% of cells suggestive a relatively unfavorable prognosis in CLL/SLL.

The final diagnosis was: Large B-cell Lymphoma in a background of CLL/SLL. This may be a composite lymphoma (a CD10+ large B-cell lymphoma along with a co-existing CLL/SLL) OR a progression/transformation of CLL/SLL.

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