Neurolymphomatosis
Lymphoma Cells: Endoneurial & Epineurial (Perivascular)
![](../pics/biopsy/nerve/lymphoma/nlyhelp.jpg)
H&E stain
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Neurolymphomatosis
Cell locations
Endoneurial: Subperineurial; Internal; Perivascular
Epineurial: Perivascular
![](../pics/biopsy/nerve/lymphoma/nlyhehp.jpg)
H&E stain
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![](../pics/biopsy/nerve/lymphoma/nlyhehp2.jpg)
H&E stain
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| ![](../pics/biopsy/nerve/lymphoma/nlyhehp3.jpg)
H&E stain
![](../pics/biopsy/nerve/lymphoma/nlyhemp.jpg)
H&E stain
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![](../pics/biopsy/nerve/lymphoma/nlycellshe2sm.jpg)
H&E stain
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Neurolymphomatosis: Lymphocytes, Atypical
Locations: Subperineurial & Endoneurial
Cells
Nuclei: Large; Atypical; Nucleoli, One or more
Cytoplasm: Minimal
Mitotic activity
![](../pics/biopsy/nerve/lymphoma/nlycellshe.jpg)
H&E stain
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![](../pics/biopsy/nerve/lymphoma/nlycd20vlp.jpg)
CD20 stain
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Lymphocytes, neoplastic: Cell features
B-cells: CD20 stain
Proliferating: Ki67 stain
![](../pics/biopsy/nerve/lymphoma/nlyki67lp2.jpg)
Ki67 stain
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![](../pics/biopsy/nerve/lymphoma/nlycd20hp.jpg)
CD20 stain
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Lymphocytes, neoplastic: Cell features
B-cells: CD20 stain
Proliferating: Ki67 stain
![](../pics/biopsy/nerve/lymphoma/nlyki67.jpg)
Ki67 stain
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![](../pics/biopsy/nerve/lymphoma/nlycd20vesslp.jpg)
CD20 stain
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Lymphocytes, neoplastic, around large vessels: Cell features
B-cells: CD20 stain
Proliferating: Ki67 stain
Ki67 stain
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![](../pics/biopsy/nerve/lymphoma/nlycd3lp.jpg)
CD3 stain
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Lymphocytes around small vessels: Cell features
T-cells: CD3 stain
Not neoplastic
![](../pics/biopsy/nerve/lymphoma/nlycd3vess.jpg)
CD3 stain
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Axon Loss: Differential fascicular
Patchy: More in some fascicles than others
Axon loss: More in some fascicles than others
Axon loss
More in some fascicles than others
Large > Small
ATPase stain: Lost in some fascicles but not others
Axon loss, Chronic: Regions of P0 staining with no axons (Arrow)
![](../pics/biopsy/nerve/lymphoma/nfgp0r.jpg)
Neurofilament (Axons) = Green & Yellow; P0 = Red
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References
1.
Diagn Cytopathol 2010;38:208-212
3/12/2019