<prompt> A 68 year old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 gdl, platelet count 27 x 109L and total leukocyte count 40 x 109L, which included 80 mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD19, CD5, CD20 and CD23 and were negative for CD79B and FMC-7. The histopathological examination of the lymph node in this patient will most likely exhibit effacement of lymph node architecture by?A monomorphic lymphoid proliferation with admixed proliferation centersA polymorphous population of lymphocytes, plasma cells, eosinophils and scattered large binucleated cellsA predominantly follicular pattern with variably-sized follicles effacing nodal architectureA diffuse proliferation of medium to large lymphoid cells with high mitotic rate.  <response>: This is a case of elderly female with lymphadenopathy, splenomegaly and peripheral blood lymphoid cells were positive for CD19, CD5, CD20 and CD23 and negative for CD79B and FMC-7. This findings are consistent with a diagnosis of Chronic lymphocytic leukemia. In CLL, lymph node biopsy is suggestive of pseudofollicular pattern with proliferation centers. Remember that, CLL lymph nodes show a low mitotic rate. This rules out option D Option B suggests Hodgkin lymphoma Option C suggests Follicular Lymphoma Option D suggests a high grade NHL with high mitotic rate Small fraction of tumors transform to aggressive tumors resembling diffuse large B cell lymphoma Richter transformation; after transformation occurs, the median survival is less than 1 year. 