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CD5+ DLBCL

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HemePath_DLBCL_Abdomen3_Centroblastic.jpg

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CD5+ diffuse large B-cell lymphoma (DLBCL) in an adult male who presented with abdominal lymphadenopathy. The tumor cells were positive for CD20, CD5, BCL2, CD43, and Ki67 (80%). They were negative for ALK-1, BCL6, TdT, CD10, and cyclinD1.

About 10% of DLBCLs express CD5. The median age at presentation is 7th decade with a slight female predominance. Morphologically, CD5+ DLBCL is indistinguishable from DLBCL, NOS. Most cases are composed of centroblasts (as shown in this image). About 20% of cases have an intravascular or intrasinusoidal growth pattern. Besides pan-B markers (CD19, CD20, CD22, CD79a, PAX-5) and CD5, these lymphomas frequently express BCL2 and BCL6. They are negative for CD10, CD23, and cyclinD1.

Prognosis: It is an aggressive tumor and often presents with stage III or IV disease. It is associated with worse outcome as compared to CD5 negative DLBCL. Extranodal sites such as bone marrow are frequently involved and it is prone to relapse in the central nervous system.

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