Clinical features of EBV DLBCL of the elderly:
(1) susceptible population (common in Asian, unusual in Europeans)
(2) age > 50 years of age
Histologic features suggesting EBV DLBCL of the elderly:
(1) areas of geographic necrosis
(2) high degree of expression of B cell markers (CD20, CD79a)
(3) presence of light-chain restriction
(4) prominent cytotoxic T-cell inflammatory background
(5) polymorphic lymphoproliferative disorder with immunoblastic and/or plasmacytoid differentiation
where:
• Positivity for CD15 may not be specific for classic Hodgkin's disease.
If EBV DLBCL of the elderly is suspected, then markers of EBV can be performed (EBNA2, EBV-EBER, EBV-LMP1). EBV DLBCL of the elderly shows evidence of EBV in both intermediate and large cells.
