PMC3756731_01
Gallium scintigraphy at hospital day 38 and fluoro-2-deoxy-D-glucose positron emission tomography at hospital day 56. Images of gallium scintigraphy show high up-take (arrows) in the systemic bone marrow (1A) and right sacroiliac joint (1B). Images of fluoro-2-deoxy-D-glucose positron emission tomography (1C and 1D) show abnormal uptake in some ribs, the spine, sacroiliac joint, mediastinal lymph nodes, and bilateral hilum of lung.
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Fig1
At hospital day 38, the second gallium scintigraphy showed high up-take of systematic bone marrow and in the right sacroiliac joint (Figure 1A and 1B). At hospital day 56, fluoro-2-deoxy-D-glucose positron emission tomography revealed abnormal uptake in some ribs, the spine, sacroiliac joint, mediastinal lymph nodes, and bilateral hilum of the lung (Figure 1C and 1D).
Pathology of the right inguinal lymph node. Panels 2A and 2B show hematoxylin eosin stain of the inguinal lymph node. Panel 2C shows the stain for CD 30 and Panel 2D for anaplastic lymphoma kinase (ALK).
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Fig2
The tissue section showed a variable proportion of large hallmark cells with eccentric horseshoe or kidney-shaped nuclei with an eosinophilic region near the nucleus and many scattered, atypical large lymphoid cells together with small lymphocytes (Figure 2A). Atypical lymphoid cells showed large, atypical lymphoid cells with bizarre nuclei (Figure 2B). Immunohistochemically, these cells were positive for T-cell markers (CD3, CD45RO), CD30 and CD4, but negative for B-cell markers (CD20, CD79a) and anaplastic lymphoma kinase (ALK) (Figure 2C and 2D).