PMC6176343_01
(a) Spleen tissue (H&E 200x); (b) CD8 positive spleen lymphocytes (200x); (c) spleen EBV positive cells (EBER, 200x).
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fig1
T-lymphocytes (CD3+) with predominant expression of CD8 (Figure 1(b)). The EBER highlighted several lymphocytes with integrated EBV RNA in the nucleus (Figure 1(c)). The liver showed several perivascular infiltrates of polymorphic lymphocytes likewise those found in the spleen and many monocyte-macrophage cells (CD14+, CD64+).
(a) Bone marrow pleomorphic lymphocytes (H&E 200x); (b) CD8 positive bone marrow lymphocytes (200x); (c) bone marrow EBV positive lymphocytes (EBER, 200x).
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fig2
In the bone marrow there were multiple lymphocyte with polymorphic or abnormal nucleuses (Figure 2(a)) that appeared to be almost exclusively CD8+ T-lymphocytes (Figure 2(b)). Most of these cells were EBER positive (Figure 2(c)); B-lymphocytes (CD20+, PAX-5+) were almost absent while there was an expansion of the monocyte-macrophage series (CD14 +, CD64 +).
(a) Mediastinal lymph node (H&E 200x); (b) CD8 positive lymph node lymphocytes (200x); (c) PAX-5 negative lymph node lymphocytes (200x).
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fig3
Mediastinal lymph nodes showed a diffuse proliferation of medium/large sized lymphoid elements, sometimes with single or multiple polymorphic nuclei (Figure 3(a)).