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The anaplastic variant is a rare variant of diffuse large B-cell lymphoma (DLBCL) characterized by the presence of highly anaplastic, bizarre cells that may be arranged in cohesive sheets simulating carcinoma. Multinucleated cells are frequently present. Some of the larger atypical cells may even resemble Reed-Sternberg cells. Besides irregular nuclei, the tumor cells show abundant cytoplasm, multiple nucleoli and frequent atypical mitoses.

The clinical behavior is the same as conventional DLBCL. It should not be confused with anaplastic large cell lymphoma which is ALK positive and composed of T/null cells.

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