Fig. 5: Radiological, Morphological and FISH findings in a large B-cell lymphoma with IRF4 and CCND1 rearrangement (Patient #8).

A Computed tomography (CT)-scan demonstrates a large mass in the stomach that was biopsied. B Panoramic view of the gastric biopsy obtained at relapse with a diffuse lymphoid infiltration in one of the fragments. (hematoxylin and eosin (H&E) stain, original magnification, ×50). C Higher magnification shows that the tumor is composed or medium to large-sized lymphoid cells with irregular nuclei, blastic chromatin, inconspicuous nucleoli and clear cytoplasm. (H&E stain, original magnification ×400). D Giemsa stain highlights the blastic cytology of the lymphoid cells (Giemsa stain, original magnification, ×400). E The tumor cells are positive for CD20, CD10 (F), BCL6 (G), MUM1/IRF4 (H), and cyclin D1 (I). (immunoperoxidase, original magnification ×400). J The MIB1/Ki67 stain shows a proliferation index of 100%. K FISH analysis using an IRF4 break-apart assay demonstrates a signal constellation of one colocalized signal (inset, yellow arrow) and one split signal (inset, red and green arrows) consistent with gene rearrangement. L FISH analysis using an CCND1 break-apart assay shows a signal constellation of one colocalized signal (inset, yellow arrow) and one split signal (inset, red and green arrows) consistent with gene rearrangement.