The pleural mass lesions have been biopsied:

Macroscopy: Pale tan tissue with an area of grey shiny serosal surface inked green and bisected.

Microscopy:  The biopsy consists of a nodule of highly cellular and partly necrotic malignant tumor within a fibrous connective tissue. The tumor is composed of a sheetlike proliferation of fairly uniform large cells that have hyperchromatic nuclei with occasional prominent nucleoli and a small amount of cytoplasm. Mitotic figures and apoptotic bodies are frequent. There are patches of intratumoral necrosis.

Immunoperoxidase stains:

• Positive: CD20, MUM1 (20%), BCL2, CD30 (patchy and non-uniform), EBV-LMP
• Negative: CD10, CD5, BCL6, cyclinD1, AE1/3, S100

Conclusion:  Left pleural tissue biopsy: Diffuse large B cell lymphoma, EBV+ (monomorphic post-transplant lymphoproliferative disorder).