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Case 147

Hematopathology Case

 

CLINICAL INFORMATION

  A 59 years old female presented with cervical lymphadenopathy in September 2008, and imaging studies revealed multiple enlarged left jugular lymph nodes with the largest one 1.3 cm. Subsequent FNA with flow cytometry was negative for malignancy. In October 2009, she developed thrombocytopenia, and CT showed multiple enlarged left cervical and supraclavicular lymph nodes with the largest one 2.9 cm. An open lymph node biopsy showed atypical cell proliferation with negative flow cytometry findings. In February 2010, the lymphadenapthy persisted with the largest one 2.5 cm. In August 2010, image studies demonstrated cervical enlarged lymph nodes with increasing size.
     
 
 

HE, 2

Scattered interfollicular atypical large cells. HE, 4

 
 

Scattered interfollicular atypical large cells. HE, 10

Scattered interfollicular atypical large cells. HE, 10

 
 

Scattered interfollicular atypical large cells. HE, 40

Scattered interfollicular atypical large cells. HE, 40

 
 

Scattered intrafollicular atypical large cells. HE, 20

Scattered intrafollicular atypical large cells. HE, 40

 
  Scattered intrafollicular atypical large cells. HE, 40 Scattered intrafollicular atypical large cells. HE, 40
 
 

Focal aggregates of the large atypical cells. HE, 4

Focal aggregates of the large atypical cells. HE, 10

 
 

Focal aggregates of the large atypical cells. HE, 10

Focal aggregates of the large atypical cells. HE, 20

 
 

Focal aggregates of the large atypical cells. HE, 20

Focal aggregates of the large atypical cells. HE, 40

 
 

Focal aggregates of the large atypical cells. HE, 40

Focal aggregates of the large atypical cells. HE, 40

     
 

Click here for diagnosis and case discussion.

 

Source: Department of Pathology, University of Alabama at Birmingham

Photo: Zenggang Pan

Discussion: Zenggang Pan