PMC6446123_01
(a) On the left of the picture and (b) on the right of the picture. (a) PET CT showing increased uptake in the nodule. (b) CT Chest without contrast: 14.8 mm pleural-based mass-like density in the posterior medial right upper lobe.
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fig1
He was seen by his PCP recently for follow-up of ascending aortic aneurysm and had a CT chest without contrast performed which showed 14.8 mm pleural-based nodular density in the posterior medial right upper lobe, irregular 20.5 mm right lower lobe nodule, and a 2 mm left upper lobe partially calcified nodule [Figure 1(a)]. He was a lifelong nonsmoker without any significant occupational exposures. [18F]Fluorodeoxyglucose-positron emission tomography with CT (18F -FDG PET/CT) was performed showing multiple 18F -FDG avid nodules in the right upper lobe, right lower lobe, and left upper lobe [Figure 1(b)].
The two pathology pictures are low and high power of hematoxylin and eosin-stained slides showing proliferation of small lymphocytes, a few of them exhibiting monocytoid morphology. The bottom left is CD20 immunostaining highlighting the neoplastic B cells. Bottom right is CD3 immunostaining highlighting the background benign small T cells consistent with diagnosis of marginal zone lymphoma.
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fig2
These findings support a histopathologic diagnosis of low-grade B-cell NHL most consistent with marginal zone lymphoma [Figure 2]. The patient was referred to oncology for further management.