PMC6915144_01
Mammography showing enlarged lymph node in the right axilla. No specific abnormalities were detected in the breast.
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A mammography, performed when the axillary mass, was first observed, and it did not detect any abnormality in the breast, except of an enlarged lymph node in the axilla (Figure 1).
CT revealing breast lesion with partially ill defined borders, thickening of the breast skin, and lymphedema (a) and enlarged axillary lymph nodes (b).
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In addition, CT revealed a lesion with ill-defined border in the right breast considered suspicious for primary malignancy, skin thickening, and lymphedema (Figure 2).
US revealing a small hypoechoic breast lesion with partially ill-defined borders and mild posterior acoustic enhancement.
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It was classified as BIRADS 4 (Figure 3).
Cytology: (a) breast FNA showing scattered Reed-Sternberg and Hodgkin cells admixed with lymphocytes and eosinophils (Hemacolor stain, 20X); (b) Reed-Sternberg and Hodgkin cell variants (Hemacolor stain, 40X); (c) CD30 immunoreactive Hodgkin cell in cytology smear (ABC, 40X). Histology: (d) lymph node specimen showing Reed-Sternberg and Hodgkin cells in a classic milieu (H & E stain, 25X); (e) CD30 immunoreactive Reed-Sternberg and Hodgkin cells; typical Golgi pattern of chromogen distribution (25X); (f) Reed-Sternberg and Hodgkin cells with Golgi pattern immunopositive for CD15 (25X).
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Small CD4 positive lymphocytes focally formed rosettes around Hodgkin cells (Figure 4).