Surgical Pathology Criteria–

Lymphomatoid Granulomatosis Variant of Diffuse Large B Cell Lymphoma

Differential Diagnosis

Post-transplant Lymphoproliferative Disorder Lymphomatoid Granulomatosis or Lymphomatoid Granulomatosis Lymphoma
T cell poor infiltrate T cell rich infiltrate
Not angiocentric Angiocentric
Definitionally post-transplant Rare cases post-transplant
Both contain EBV+ B cells
The distinction may sometimes be arbitrary

Wegener Granulomatosis Lymphomatoid Granulomatosis or Lymphomatoid Granulomatosis Lymphoma
No prominent lymphoid infiltrate Prominent lymphoid infiltrate
Neutrophilic microabscesses No abscesses
EBV negative EBV+ B cell population
Both are angiocentric

Extranodal NK/T Cell Lymphoma, Nasal Type Lymphomatoid Granulomatosis or Lymphomatoid Granulomatosis Lymphoma
Atypical cells are CD56+ cytotoxic T cells Atypical cells are B cells
Both may involve ENT sites and lung, are angiocentric, necrotizing and are EBV+

Hodgkin Lymphoma Lymphomatoid Granulomatosis or Lymphomatoid Granulomatosis Lymphoma
CD15 80% CD15 negative
CD20 or CD79a 20% CD20 or CD79a 100%
Background with neutrophils, eosinophils, plasma cells Background of small T cells
Rare in lung and skin Typically involves lung and skin
Both may be necrotizing, CD30+ and EBV+

Diffuse Large B Cell Lymphoma, NOS Lymphomatoid Granulomatosis Lymphoma
EBV negative EBV positive
Not angiocentric Angiocentric and angiodestructive
Prominent T cell infiltrate only in T Cell Rich Variant Prominent T cell infiltrate

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