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Neurolymphomatosis

Axon loss Cells

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Lymphoma Cells: Endoneurial & Epineurial (Perivascular)

H&E stain

Neurolymphomatosis
  Cell locations
    Endoneurial: Subperineurial; Internal; Perivascular
    Epineurial: Perivascular

H&E stain

H&E stain

H&E stain

H&E stain

H&E stain

Neurolymphomatosis: Lymphocytes, Atypical
  Locations: Subperineurial & Endoneurial
  Cells
    Nuclei: Large; Atypical; Nucleoli, One or more
    Cytoplasm: Minimal
    Mitotic activity

H&E stain

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CD20 stain

Lymphocytes, neoplastic: Cell features
  B-cells: CD20 stain
  Proliferating: Ki67 stain

Ki67 stain

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CD20 stain

Lymphocytes, neoplastic: Cell features
  B-cells: CD20 stain
  Proliferating: Ki67 stain

Ki67 stain

CD20 stain

Lymphocytes, neoplastic, around large vessels: Cell features
  B-cells: CD20 stain
  Proliferating: Ki67 stain

Ki67 stain

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CD3 stain

Lymphocytes around small vessels: Cell features
  T-cells: CD3 stain
  Not neoplastic

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

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ATPase stain: Lost in some fascicles but not others

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Axon loss, Chronic: Regions of P0 staining with no axons (Arrow)

Neurofilament (Axons) = Green & Yellow; P0 = Red

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References
1. Diagn Cytopathol 2010;38:208-212

3/12/2019