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Arch Surg. 2009;144(8):784.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Answer: Richter Syndrome With Gallbladder Localization

Macroscopically, the specimen showed a plaque of 4.5 cm next to the gallbladder neck. Histologically, Richter syndrome with gallbladder localization was observed. Two of 3 lymph nodes close the specimen showed the same histological aspects. Immunophenotypically, the neoplastic cells were intensely positive for Pan-B (MB2) and negative for CD20 and CD30. A considerable amount of T-cell lymphocytes were observed (70% CD3⁺ and CD8⁺; 30% CD5⁺) (Figure 2).

Figure appears in full text version. Figure 2. Lymphomatous involvement of the gallbladder wall infiltrating submucosa (arrows).

Richter syndrome has been defined as the transformation in a high-grade non-Hodgkin lymphoma, prolymphocytic leukemia, Hodgkin disease, or acute leukemia supervening in the course of B-CLL or small lymphocytic lymphoma.³ This secondary high-grade lymphoma, usually with diffuse large B-cells, develops in approximately 2.2% to 8% of patients.³ It occurs mostly in lymph nodes and may represent a second neoplasm or a transformation from the same lymphocytic clone population . . . [Full Text of this Article]

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