“Tissue biopsy remains essential for the histopathologic and immunophenotypic evaluation of DLBCL, as treatment decisions hinge on diagnostic accuracy. Steroids induce cytolysis of malignant B cells, resulting in apoptosis and tumor necrosis, and are therefore hypothesized to compromise diagnostic yield. Steroid-induced B-cell lysis can lead to increased infiltration by reactive macrophages and lymphocytes, potentially obscuring diagnostic features.8-10 In addition, steroids may alter cluster of differentiation (CD20) immunoreactivity—a key diagnostic marker—leading to patchy or atypical staining patterns. Radiologically, this effect has been observed as rapid tumor involution on imaging, earning the descriptor ghost tumor. Nonetheless, more recent evidence suggests that a steroid administration before baseline positron emission tomography or computed tomography does not diminish diagnostic yield in DLBC.”
Surgical Focus 