PMC3285033_01
Histopathological findings of lymph node at the initial presentation. (A) The architecture of lymph node was effaced by a diffuse polymorphic infiltration composed of small- to medium-sized lymphoid cells, immunoblastic cells and scattered eosinophils around high-endothelial venules. (B) Multinucleated cells with eosinophilic nucleoli resembling Reed-Stemberg (RS) cells could be observed in the lymph node. (C) Immunohistochemical examination revealed that infiltrated small to medium-sized lymphoid cells were diffusely positive for CD3, but large immunoblast-like cells and RS-like cells were positive for CD20 (D) and CD30 (E).These larger cells were also positive for EBER by in situ hybridization (F).(A, H&E staining, with original magnification x400; B, H&E staining, with original magnification x600; C-E, immunohistochemical staining, with original magnification x400; F, EBER-in situ hybridization, with original magnification x400).
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F1
In addition, scattered Reed-Sternberg (RS)-like cells with irregular multilobated nuclei and large eosinophilic nucleoli were also present in the node (Figure 1A-B). B immunoblasts or RS-like cells (Figure 1C-F). Based on clinical presentation and histological findings, a histological diagnosis of angioimmunoblastic T-cell lymphoma (AITL) was made according to the criteria of WHO classification.
Histological findings of skin lesion. (A) Low power view of skin lesion showed diffuse infiltration of lymphoid cells in dermal and subcutaneous tissue without epidermotropism. (B) Large atypical lymphoid cells with prominent nucleoli were observed in the skin lesion. Atypical large lymphoid cells were stained positively with CD20 (C) and CD79a (D). However, CD3 positive cells in skin lesion were small lymphocytes with scattered distribution (E). (F) Most of atypical large cells were positive for EBER by in situ hybridization. (A, H&E staining, with original magnification x40; B, H&E staining, with original magnification x400; C-E, immunohistochemical staining, with original magnification x400; F, EBER-in situ hybridization, with original magnification x400).
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F2
Cellular atypia exhibited irregular nuclei, large nucleoli and vesicular chromatin with a brisk mitotic rate, atypical mitotic figures (Figure 2A-B). EBV detection by in situ hybridization for EBERs showed diffuse positive reaction (Figure 2C-F).