Angioimmunoblastic T-cell lymphoma (AITL). (A–C) – Hematoxylin-eosin (HE), optical microscopy, magnifications of 10 x (A), 20 x (B) and 40 x (C). Proliferation of small/medium sized atypical lymphoid cells diffusely infiltrating the lymph node with marked vascular proliferation. (D) high-rate of cell proliferation index - positive Ki-67 in more than 80% of the nuclei of atypical lymphoid cells. (E) Strong and diffuse labeling for the pan-T CD3 antigen. (F) Rare large CD20-positive cells in the paracortical region (“immunoblasts”). (G) CD4-positive in most neoplastic cells. (H) CD8-negative in neoplastic cells and positive in rare small reactive lymphocytes. (I) CD30-positive in large, expanded cells in the paracortical region with RS-like morphology. (J) Exuberant vascular proliferation with high endothelial venules (VEA) enhanced by CD34. (K) Expanded follicular dendritic cell (FDC) meshwork, labeling for CD21. (L) BCL6 positive and (M) CD10 positive, both markers of TFH origin. (N, O)
In situ hybridization (ISH) for EBV, positivity for EBERs (Epstein-Barr small encoded-RNAs), staining in black, “speckled” pattern, revealing EBV staining in RS-like immunoblasts in the paracortex. (D–F, H, L–N) – Optical microscopy, 10 x magnification. (I, J, O) – Optical microscopy, 20 x magnification; (K) – Optical microscopy, 40 x magnification.