PMC7381955_01
Computed tomography of the chest showing the rapidly expanding mediastinal lymphadenopathy. The trachea was compressed with the narrow diameter of <1 cm. (a) Pretreatment. (b) Day 14 following commencement of treatment.
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fig1
An urgent computed tomography scan demonstrated cervical and mediastinal lymphadenopathy resulting in tracheal compression (see Figure 1).
Sheets of large lymphocytes with centroblastic morphology ((a) haematoxylin and eosin stain), with positive immunohistochemistry for high Ki-67 index of 70%, CD20, and MUM1 (b)-(d), respectively.
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fig2
Based on paraffin section immunohistochemistry, the neoplastic cells were positive for CD20, CD5 (weak), CD23, CD43, BCL2 (>70%), and MUM1 and were lambda light-chain restricted; the Ki-67 proliferation index was approximately 70% (See Figure 2).