PMC3513813_01
(a) The growth over the left tonsil. (b) CT scan shows the growth on the left tonsil
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F1
Intraoral examination revealed a red swelling over the left tonsil [Figure 1a]. Tomography (CT) scan showed a growth arising from the left tonsil [Figure 1b].
(a) Photomicrograph showing a tumor situated underneath the squamous epithelial lining and lymphoid follicles of the tonsil. (Hematoxylin and Eosin, x100). (b) Photomicrograph showing continuous sheet of spindle-shaped tumor cells with elongated plump-shaped nuclei arranged in fascicles and storiform pattern with distinct whorling with 360 degree rotation of the tumor cells [Black bordered box] and multinucleated giant cells. [Inset] (Hematoxylin and Eosin, x400)
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F2
Microscopical examination revealed a tumor situated underneath the squamous epithelial lining and lymphoid follicles of the tonsil [Figure 2a]. The tumor was composed of continuous sheets of spindle cells with elongated plump-shaped nuclei arranged in fascicles and in storiform pattern [Figure 2b]. Most strikingly, there were frequent distinct whorling of the tumor cells with 360 degree rotation [Figure 2b (Black bordered box)]. Occasional multinucleated giant cells [Figure 2b (Inset)] and mitotic figures were also noted along with evidence of lymphocytic infiltration.
(a) Tumor cells showing strong membrane positivity for CD21. The 360 degree whorling pattern can be easily appreciated. (b) Tumor cells showing strong membrane positivity for CD3
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F3
CD21 [Figure 3a], CD35 [Figure 3b] and CD23.