PMC6546941_01
The liver is involved by an atypical small lymphoproliferation within sinusoids and forming atypical expansile aggregates involving portal tracts. There was no evidence of large nodules or sheets of large cells. The histologic differential includes acute hepatitis (hematoxylin-eosin, original magnification x10).
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A liver biopsy was performed and pathology revealed an atypical proliferation of small/medium-sized lymphoid cells involving the hepatic parenchyma (Figure 1).
CD20 immunostaining highlights the atypical lymphoproliferation extensively involving the sinusoids (original magnification x10).
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Immunohistochemical studies (IHC) showed a marked predominance of atypical CD20-positive B-cells consistent with B-cell lymphoma (Figure 2).
The atypical lymphoid cells are small/medium in size with variable irregular hyperchromatic nuclei. Note the bile ducts in the center of the field (hematoxylin-eosin, original magnification x40).
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The lesional cells were predominantly distributed within sinusoids with expansion and forming medium-sized atypical aggregates involving portal tracts, evidenced by intact bile ducts centered within the aggregates (Figure 3).