PMC5757208_01
The results of swollen lymph node biopsy section.. Notes: (A) Diffuse proliferation of homogeneous midsized lymphoid cells with ovoid or pleomorphic nuclei, small or inconspicuous nucleoli and hypochromic chromatin (x400). (B) CD123 positive for neoplasm cells (x400). (C) CD4 positive for neoplasm cells (x400). (D) CD56 positive for neoplasm cells (x400).
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The inguinal lymph node biopsy showed effacement of normal nodal architecture by diffuse proliferation of homogeneous midsized lymphoid cells with ovoid or pleomorphic nuclei, small or inconspicuous nucleoli, hypochromic chromatin and red blood cells and small lymphocytes dispersed within them (Figure 1A). Immunohistochemical analysis showed that the neoplastic cells were positive for CD43, indicating hematopoietic malignancy, and were specifically positive for CD123, CD4 and CD56 (Figure 1B-D) but negative for all other markers examined, including T-cell (CD3, CD2, CD5, CD8), B-cell (CD20, CD79a), myeloid- or monocytic-associated (MPO, CD34) markers.
Change in skin lesions.. Notes: (A) Large skin lesions on the face before therapy. (B) Almost disappearance of skin lesions after two cycles of chemotherapy.
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After 5 months, with progressive diffuse lymphadenopathy, facial skin lesions (Figure 2A), conjunctival congestion and dyspnea on exertion, the patient returned to the hospital for further treatment. In the first CR, there is no lymphadenopathy, no skin lesions (Figure 2B) and no plasmacytoid juvenile cells in the bone marrow or peripheral blood.