Sections from the right axillary lymph node demonstrate effacement of the lymph node architecture by a diffuse lymphohistiocytic infiltrate with patchy areas of necrosis and multiple vaguely perivascular clusters and singly scattered large Hodgkin-like cells with wreath-like nuclei somewhat reminiscent of lymphomatoid granulomatosis, grade 3.

The histologic features are intermediate between cHL, LyG grade 3 and T/HRLBCL without any areas displaying sheets of large centroblastic or immunoblastic cells. 

Immunostains show that the large cells are uniformly positive for CD20, and Oct-2. Additional B-cell markers including CD79a, Pax5 (not shown) were also positive indicative of a well preserved B-cell program. The backgound is rich in CD3+ T-cells. There was also weak CD5 expression in the large cells (not shown). Rare large cells express weak CD30 but there is strong uniform CD15 with weak variable Mum1 (usually strong in pure cHL).

 Notably, most of the lymphoma cells are moderately positive for PD-L1.