PMC2684294_01
Imaging picture showing a plaque-like lesion in the bladder
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The imaging [Figure 1] and cystoscopic examination revealed a localized 2.5 cm plaque-like mucosal mass on the right posterior and lateral wall of the bladder and a biopsy sample was obtained from the lesion.
Tumour shows diffuse, large, atypical polymorphic lymphoid infiltrates (H&E, x400)
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H&E sections showed a diffuse and densely atypical polymorphous mixed small and large lymphoid infiltrate involving mucosa and deep muscles of the bladder [Figure 2].
Most large, atypical lymphoid cells are CD20 positive. x400
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The large atypical cells were CD20+ [Figure 3], CD79a+, CD30+9 [Figure 4], CD43+, EMA+ (focally); but negative for CD2, CD5, CD8, CD4, CD7 and myelomonocytic markers including (myeloperoxidase) MPO, CD117, CD68 (PGM-1), as well as CD10, terminal deoxynucleotidyl transferase (Tdt) and ALK-1.
Many cells also show CD30 positivity. x200
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The large atypical cells were CD20+ [Figure 3], CD79a+, CD30+9 [Figure 4], CD43+, EMA+ (focally); but negative for CD2, CD5, CD8, CD4, CD7 and myelomonocytic markers including (myeloperoxidase) MPO, CD117, CD68 (PGM-1), as well as CD10, terminal deoxynucleotidyl transferase (Tdt) and ALK-1.
Most cells are EBV positive (anti -EBER probe), x 200
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The majority of atypical large lymphoid cells were strongly positive for EBV by ISH using anti-EBER-1 probe [Figure 5].