PMC10364003_01
Timeline depicting various treatments against Hodgkin's lymphoma over the years. ABVD, adriamycin-bleomycin-vinblastine-dacarbazine; RICE, rituximab-ifosfamide-carboplatin-etoposide; SCC, squamous cell carcinoma; HL, Hodgkin's lymphoma.
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Positron emission tomography-computed tomography (PET-CT) in March 2006 post completion of ABVD regimen (doxorubicin at the dose of 25 mg/m2, bleomycin at 10 mg/m2, vinblastine at 6 mg/m2, and dacarbazine at 375 mg/m2) showed complete response (Figure 1).
Histology images of Merkel cell carcinoma and squamous cell carcinoma. (A) Hematoxylin and eosin-stained section (pictured: x40 objective) of right ear biopsy showing solid sheets of tumor cells with high N:C ratios, round to oval nuclei with a characteristic "salt and pepper" chromatin pattern and some areas with nuclear molding. Atypical mitoses and apoptotic bodies are present. These histopathological features, when combined with the patient's clinical history and tumor immunoreactivity to CK20 (not pictured), suggest a diagnosis of Merkel cell carcinoma. (B) Hematoxylin and eosin-stained sections (top: x4 objective, bottom: x10 objective) of right side of base of the tongue biopsy showing invasive squamous cell carcinoma in a background of atypical squamous proliferation with focal papillary features. Significant architectural complexity of the squamous epithelium favors an invasive component to this lesion. N:C, nuclear to cytoplasmic.
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Pathology revealed Merkel cell carcinoma (MCC) (Figure 2A). Triple scope performed during the procedure with laryngoscopy, bronchoscopy and esophagogastroduodenoscopy revealed an incidental 5x5 mm exophytic mass on the right base of tongue, biopsy of which was found to be invasive SCC (Figure 2B).