PMC9428397_01
Features of the tumor. (A) Right neck ultrasonography shows a hypo-echoic region with abundant blood flow surrounding the right common carotid artery, which has normal internal blood flow. White arrow indicates the right common carotid artery. (B) The trunk positron emission tomography/computed tomography shows a large mass in the right neck surrounding the adjacent large vessels, which had a non-uniform increase in radioactive uptake. Red arrow indicates the tumor.
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F1
Neck ultrasonography showed a hypo-echoic region with abundant blood flow in the lower middle part of the right neck, approximately 9.0 cm x 8.2 cm x 4.4 cm, surrounding the right common carotid artery, which had normal internal blood flow (Figure 1A). Positron emission tomography (PET)/CT showed a large soft tissue mass in the right neck, approximately 8.6 cm x 5.0 cm x 11.0 cm, surrounding the adjacent large vessels (Figure 1B).
Left inguinal lymph node biopsy shows diffuse large B-cell lymphoma. (A) Large, round, or ovoid tumor cells are seen, with some cells having an irregularly shaped nuclear membrane. Single large or multiple small nucleoli can be seen in the tumor cells, and nuclear division is more common (H and E, x 200). (B) Immunohistochemistry stain of CD 20 shows the tumor cells were uniformly and strongly positive (x 200). (C) Immunohistochemistry stain of CD 3 shows the tumor cells are negative, but the T lymphocytes in the background are positive (x 200). Black arrow indicates the tumor cell. White arrow indicates the T lymphocyte.
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F2
Histopathological examination showed highly invasive B-cell lymphoma with a morphology consistent with diffuse large B-cell lymphoma (Figure 2).
The trunk positron emission tomography/computed tomography shows significant shrinkage of the original large mass in the right neck after four cycles of immunochemotherapy. (A) After immunochemotherapy for four cycles. (B) Before the immunochemotherapy. Red arrow indicates the tumor.
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F3
After four cycles of R-CHOP immunochemotherapy, PET/CT revealed that the original large mass in the neck had disappeared (Figure 3).