Compare the staining here with that in an adjacent section below. This one is stained for kappa light chains. Note that most of the infiltrating cells have a positive brown stain.
Low Grade Lymphoma
Low-grade lymphoma of BALT
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Compare the staining here with that in an adjacent section below. This one is stained for kappa light chains. Note that most of the infiltrating cells have a positive brown stain. | ||||||
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This section is stained for lambda light chains. Few positive cells are present. Inflammatory reactions would show similar numbers of kappa and lambda-reactive cells. The restriction of most of the staining to the kappa-positive cells indicates clonality and hence, neoplasia. | ||||||
Angioimmunoproliferative Lesion/Lymphomatoid Granulomatosis
This disease is an extranodal lymphoproliferative disorder with a prominent polymorphous, reactive inflammatory component. It has been divided into two grades depending on the number of atypical cells present. Radiographs usually show multiple nodules with or without cavitation, bilaterally. Cutaneous and peripheral nerve manifestations may accompany it. The atypical cells stain with B-cell markers, show rearrangement of the heavy chain gene, and often stain with markers for E-B virus.
Angioimmunoproliferative lesion
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Histologic features include:
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AIL stained with the B-cell marker CD20
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The large atypical cells stain with the B-cell marker (center). Some small lymphocytes stain with the B-cell marker, but many of them react with a T-cell marker. Both, however, are considered to be non-neoplastic, reactive lymphocytes. | ||||||
Destructive angioinvasion
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Destructive narrowing and occlusion of medium-sized vessels by tumor is a characteristic feature of AIL and high-grade, large cell lymphomas, as well. As a result, ischemic necrosis of tumor is common. The arrows indicate the outer borders of the vessel wall. An elastic van Gieson stain is useful to find these obstructed vessels. | ||||||
