PMC4677179_01
Histology of the nasal septal biopsy. (a) H&E High Power showing immature cells with hyperchromatic nuclei, occasional nucleoli, and high nuclear cytoplasmic ratios. (b) CD34 immunohistochemistry: positive membranous staining (CD34 marker of immature cells). (c) PAX-5 immunohistochemistry: positive nuclear staining (PAX-5 is a broad-spectrum B-lymphoid lineage marker). (d) Tdt immunohistochemistry: positive nuclear staining (Tdt marker of immature cells, favouring lymphoblastic lineage).
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fig1
Histology showed a monomorphic infiltrate of immature cells positive for CD19, PAX-5, HLADR, CD34, Tdt, and CD56 consistent with a diagnosis of B-cell ALL (Figure 1).
Imaging showing nasal septal lesion. CT images: (a) axial, (b) coronal, and (c) sagittal view. Endoscopic view left side: (d) lesion arising from the posterior part of the left nasal septum.
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fig2
The LDH level was normal, CT demonstrated a nasal mass at the posterior septum extending into the nasopharynx (Figure 2), and there was no evidence of disease in the neck, chest, and abdomen.