PMC3420647_01
Histological and immunohistochemical analysis of posttransplant EBV-associated diffuse large B-cell lymphoma in the CNS. (a) H&E section showing diffuse infiltration by large neoplastic lymphocytes (x20). (b) Immunohistochemistry showing neoplastic lymphocytes are strongly positive for CD20 (x20). (c) Immunohistochemistry showing scattered tumor cells positive for EBV (x20).
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fig1
The large cells displayed pleomorphic nuclei, with prominent nucleoli, some of which had immunoblastic appearance (Figure 1(a)). Immunohistochemical studies showed the large atypical cells to be positive for CD20 (Figure 1(b)). The histological diagnosis of the tumor was diffuse large B-cell lymphoma, and EBV was detected in the tumor cells by immunohistochemistry for latent membrane protein-1 (LMP-1) (Figure 1(c)).
(a) Axial contrast-enhanced MR image of the cerebrum showing a 3.8 x 7.8 cm tumor infiltrating the parietooccipital region of the right hemisphere. The lesion is with surrounding edema and compressing the right lateral ventricle and the right side of the mesencephalon. (b) Four weeks after start of treatment, a resection cavity with a modest enhancement against the calvaria is seen. The centre line is in normal position, and the content of the cavity is isodense with the cerebrospinal fluid.
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A magnetic resonance imaging (MRI) of the CNS showed a 3.8 x 7.8 cm tumor infiltrating the right parietooccipital region; there was surrounding edema and compression of the right lateral ventricle and right side of the mesencephalon (Figure 2(a)). After 4 weeks of treatment, an MRI demonstrated a complete regression of the CNS lesion and resolution of the displacement of the ventricular system (Figure 2(b)).
PMC3420647_02
Histological and immunohistochemical analysis of posttransplant EBV-associated plasmacytoma in the CNS. (a) H&E section of a tumor showing a solid infiltrate of atypical malignant plasma cells (x40). (b) The plasma cells are positive for lambda light chains by immunophenotyping (x20). (c) Immunohistochemistry showing scattered tumor cells positive for EBV (x20).
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fig3
A stereotactic brain biopsy was performed; this revealed atypical, malignant plasma cells (Figure 3(a)). The plasma cells were monoclonal for lambda light chains by immunophenotyping (Figure 3(b)), and EBV genome was detected in the tumor cells by immunohistochemistry for LMP-1 (Figure 3(c)).