PMC8575600_01
Flexible nasopharyngoscopy showing the polypoid mass in the nasopharynx.
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Flexible nasopharyngoscopy demonstrated an enlarged, polypoidal mass arising from the nasopharyngeal wall (Figure 1).
Coronal CT imaging of the neck showing right-sided cervical lymphadenopathy.
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A contrast-enhanced computed tomography (CT) of the patient's neck confirmed right-sided cervical lymphadenopathy of the lateral compartment (Figure 2) and a nasopharyngeal mass (Figure 3).
Axial CT imaging of the head showing the nasopharyngeal mass.
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A contrast-enhanced computed tomography (CT) of the patient's neck confirmed right-sided cervical lymphadenopathy of the lateral compartment (Figure 2) and a nasopharyngeal mass (Figure 3).
Erythematous skin lesion.
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At his outpatient clinic follow up visit, the patient reported fevers, night sweats, an erythematous skin lesion distributed over his right chest (Figure 4), and an increase in the size of the right-sided cervical lymph nodes (Figure 5).
Progressive neck swelling.
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At his outpatient clinic follow up visit, the patient reported fevers, night sweats, an erythematous skin lesion distributed over his right chest (Figure 4), and an increase in the size of the right-sided cervical lymph nodes (Figure 5).
(a) At low magnification, focal effacement of lymph node architecture by cohesive infiltrate of neoplastic cells, extending from the subcapsular sinuses into the paracortical region. (b) At high magnification, large pleomorphic neoplastic cells with abundant eosinophilic cytoplasm, pleomorphic nuclei, and frequent mitotic figures, including a "hallmark" cell with horseshoe-shaped nuclei (blue arrow).
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The pathological analysis yielded focal effacement of the lymph node architecture by large cells with abundant eosinophilic cytoplasm, pleomorphic nuclei, and frequent mitotic figures (Figures 6(a) and 6(b)).
(a) At high magnification, strong, uniform CD 30 positivity in the cytoplasmic membranes and Golgi regions of the neoplastic cells. (b) At high magnification, diffuse cytoplasmic and nuclear staining for ALK.
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The immunohistochemical test results demonstrated strong and diffuse, positivity for CD30 and ALK in the tumour cells (Figures 7(a) and 7(b)).
PMC8575600_02
(a) Resolution of skin lesion. (b) Resolution of right cervical lymphadenopathy.
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The chemotherapy course was well received by the patient as the cervical lymphadenopathy, nasal mass, skin lesions, and constitutional symptoms resolved (Figures 8(a) and 8(b)).