Manuscript:
Introduction : Diffuse Large B-Cell Lymphoma (DLBCL) is the most
common type of Non-Hodgkin lymphoma. Patients may have a variable
clinical presentation and it may be nodal or extranodal. The
4th edition World Health Organization (WHO) guidelines
for tumors of hematopoietic and lymphoid tissues, 2008 defined DLBCL as
neoplasm of large B-cell arranged in a diffuse
pattern.1 In 2016 it was revised and updated to
include details on cell of origin classification (COO), CD5 expression
on prognosis, double expressor lymphoma (DEL) and further understanding
of high grade-B cell lymphoma.2
The diagnoses for most cases of lymphoma are managed with biopsies and
the support of immunohistochemical (IHC) markers. CD3 and CD20, are
membranous stains and the most basic initial step in identifying T and B
cell lymphoma. However, the diagnosis can sometimes be challenging, like
the cases described here where steroids may alter the antigen expression
of the neoplasm and present a major challenge clinically and
diagnostically for pathologists. We have discussed the implications of
steroid use and the importance of sound knowledge of staining patters of
different antibodies to correctly interpret membrane and nuclear
staining antibodies also highlighting the importance of proper controls.