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Differential Diagnosis for B Cell CD10 Positive in Pleural Effusion

Single Most Likely Diagnosis

  • Diffuse Large B Cell Lymphoma (DLBCL): This is the most common type of non-Hodgkin lymphoma, and CD10 positivity is seen in a subset of cases, particularly those with a germinal center B cell-like (GCB) subtype. The presence of B cells in pleural effusion suggests a possible lymphomatous involvement.

Other Likely Diagnoses

  • Follicular Lymphoma: Although less common than DLBCL, follicular lymphoma can also present with CD10 positive B cells. It typically has a more indolent course but can involve unusual sites like the pleura.
  • Burkitt Lymphoma/Leukemia: This aggressive B cell malignancy is CD10 positive and can present in various extranodal sites, including the pleura, though it is less common.

Do Not Miss Diagnoses

  • Mantle Cell Lymphoma: Although typically CD10 negative, a small subset of mantle cell lymphomas can express CD10. Given its aggressive nature and potential for extranodal involvement, it's crucial not to miss this diagnosis.
  • Acute Lymphoblastic Leukemia (ALL): Some cases of ALL, particularly those of B cell lineage, can be CD10 positive. Involvement of the pleura can occur, and missing this diagnosis could have severe consequences due to the aggressive nature of ALL.

Rare Diagnoses

  • Lymphoblastic Lymphoma: A rare and aggressive form of non-Hodgkin lymphoma that can be CD10 positive. It is more commonly associated with T cell lineage but can rarely be of B cell origin.
  • Primary Effusion Lymphoma: A rare type of lymphoma associated with human herpesvirus 8 (HHV-8), typically seen in immunocompromised patients. While it is usually CD10 negative, rare cases might express CD10, making it a consideration in the differential diagnosis of B cell lymphomas in pleural effusions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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