PMC3085326_01
PET-CT demonstrated a focus of avidity at the known cerebellopontine lesion, as well as in the posterior inferior wall and papillary muscle of the left ventricle of the heart.
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fig1
A positron emission tomography with computed tomography (PET/CT) was then performed and demonstrated increased uptake at the known cerebellopontine lesion, as well as in the posterior inferior wall and papillary muscle of the left ventricle of the heart (Figure 1). Immunostains of the atypical lymphoid cells were strongly KSHV+ (Figure 2), MUM1/IRF4+, CD79a rare+, CD20-.
(a) Cerebrospinal fluid contains rare large, atypical cells with lobated nuclei and abundant basophilic cytoplasm; scattered smaller nonneoplastic cells are also present. (b)-(d) Endomyocardial biopsy. Microscopic examination by hematoxylin and eosin stain shows an atypical lymphoid proliferation infiltrating the myocardium (b). Higher power revealed large atypical discohesive cells with few admixed eosinophils (c). Large lymphoid cells stained avidly for Kaposi's sarcoma herpesvirus by immunostain (d).
ART2011-729854.002.jpg
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fig2
Cerebral spinal fluid (CSF) cytology was notable for atypical appearing cells, which were suspicious for, but not sufficient for a primary diagnosis of malignancy (see Figure 2(a)). Immunostains of the atypical lymphoid cells were strongly KSHV+ (Figure 2), MUM1/IRF4+, CD79a rare+, CD20-. Comparison with the CSF specimens showed that these atypical cells were morphologically similar to the suspicious cells in the CSF (Figure 2(a)).