2022 Volume 61 Issue 2 Pages 116-121
Background : We report a case of diffuse large B-cell lymphoma (DLBCL), in which fine-needle aspiration cytology revealed a large number of multinucleated giant cells showing emperipolesis-like features.
Case : The patient was a male in his second decade of life who presented with a mass in the left neck that he had first noticed two months earlier. Findings of MRI and neck ultrasonography led to the suspected diagnosis of malignant lymphoma or schwannoma. Cytological examination revealed small- to large-sized atypical lymphocytes admixed with a large number of macrophages and multinucleated giant cells. The multinucleated cells showed intracytoplasmic inclusions containing lymphocytes, a finding that was considered as being emperipolesis-like. Similar to the cytological findings, intraoperative frozen section examination also revealed diffuse infiltration of small- to intermediate-sized lymphocytes admixed with macrophages and multinucleated giant cells. However, on permanent-section histopathology, while diffuse infiltration of lymphocytes was observed, histiocytes and multinucleated giant cells were indistinct. Immunohistochemically, the background atypical lymphocytes showed diffuse and strongly positive staining for CD 20, while the histiocytes and multinucleated giant cells showed negative staining for CD20, S-100 and CD1a, and positive staining for CD68 and CD163. Based on the findings, we made the final diagnosis of DLBCL with reactive infiltration of histiocytes and multinucleated giant cells showing emperipolesis-like features.
Conclusion : Multinucleated giant cells showing emperipolesis-like features is a rare, but possible finding in DLBCL.
