Clinical history: A 69 year old male admitted to ICU with respiratory distress. Bronchial wash performed. Requisition stated “Acute Intestitial Pneumonia”
What is your diagnosis?
Discussion and answer
A highly cellular specimen consisting of abundant mature appearing lymphocytes with slight atypia noted on high power, raising the possibility of a lymphoma or leukemia. Further clarification of patient history revealed a history of CLL.
These findings are keeping with patients’ diagnosis of transformation of large B-cell lymphoma.