#00061555

This patient is a 53-year-old female with history of end-stage renal disease status post renal transplantation with an enlarged left neck lymph node undergoing excisional biopsy. The image demonstrates perivascular cuffing by large lymphoid cells with variably angulated nuclei, vesicular chromatin, prominent nucleoli, and scant cytoplasm in an effaced background of extensive necrosis with some scattered ghost cells. Immunohistochemical stains showed the large cells brightly express PAX-5, CD20, and CD30 while lacking CD15. The cells are also diffusely positive for EBV in situ hybridization. In the context of the morphologic findings, this expression profile is diagnostic of post-transplant lymphoproliferative disorder consistent with EBV-positive diffuse large B-cell lymphoma. The angiocentric pattern of involvement seen here is reminiscent of the lymphohistiocytic infiltrate seen in lymphomatoid granulomatosis.