PMC9124141_01
Chest computed tomography scans. (a) The initial scan shows a solid nodular lesion with irregular margins and adjacent to the visceral pleura in the right lower part of the upper lobe. (b) Five years later, the CT scan revealed only a small scar in the former lesion.
CRIM2022-2242418.001.jpg
PMC9124141_01_CRIM2022-2242418.001.jpg
fig1
This finding was confirmed by computed tomography (CT) showing a solid nodular lesion with irregular margins adjacent to the visceral pleura with a diameter of 1.2 inches in the upper right lobe (Figure 1).
Histopathological appearances of the tumour. (a, b) Lymphoproliferative lesion was composed of dense infiltrates of mature lymphocytes and sporadic plasma cells along with lymphoid follicles with germinal centers. (a) Hematoxylin-eosin (H&E), x10. (b) H&E, x40. (c, d):Immunohistochemical (IHC) staining for immunoglobulin (Ig) k (c) and Ig lambda. (d) Light chains revealed polyclonal reactivity (x40). (e) IHC staining using CD20 antibodies showed high densities of B cells in reactive follicles. (f) Ki-67 IHC staining revealed high proliferative activity in the germinal center with no evidence of malignancy.
CRIM2022-2242418.002.jpg
PMC9124141_01_CRIM2022-2242418.002.jpg
fig2
Under suspicion of malignancy, a CT-navigated core biopsy (diameter: 0.75 inches) was obtained showing well-defined lymphoid tissue masses with numerous reactive germinal centers, interfollicular lymphocytes, and plasma cells (Figure 2). CD20 and CD10 identified B cells, which were negative for Bcl-2 (Figure 2(e)). CD3-positive T cells showed reactive patterns in the interfollicular zone. Ki-67 staining confirmed a high proliferative activity in reactive follicles with no evidence of malignancy (Figure 2(f)).