PMC4100463_01
A, -H: FNA cytology of a left axillary lymph node: Cellular smears with a monomorphic lymphoid population and increased intermixed eosinophils (arrows) (C-1A, Diff-Quik, 600x). Medium-sized lymphoma cells showed high N:C ratio, dispersed chromatin with indistinct nucleoli, and scant cytoplasm (C-1B, Papanicolaou, 600x). Eosinophils are easily identified on Diff-Quik stain by brightly eosinophilic granules (C-1C, Diff-Quik, 1,000x) Eosinophils characteristically have bi-lobed nuclei identified on Papanicolaou stain, but granules are not readily identified (C-1D, Papanicolaou, 1,000x). Occasional eosinophilic precursors (eosinophilic myelocytes) characterized by unilobation and mixed eosinophilic and basophilic granules (C-1E and 1F, Diff-Quik, 1,000x). Features of eosinophilic abnormalities including nuclear hyposegmentation (C-1G, Diff-Quik, 1,000x) and sparse granulation with clear cytoplasmic areas (C-1G and 1H, Diff-Quik, 1,000x).
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Medium-sized neoplastic lymphoid cells showed high N:C ratio, dispersed chromatin, indistinct nucleoli, and scant cytoplasm (Fig.C-1B). Eosinophils were increased (Figs.C-1C and D) with occasional eosinophilic precursors (Figs.C-1E and F) and eosinophilic abnormalities including nuclear hyposegmentation and sparse granulation with clear cytoplasmic areas (Figs.C-1G and H).
A: -D: Subsequent corresponding excisional biopsy of a left axillary lymph node demonstrated diffuse infiltration by a population of medium-sized to large neoplastic lymphoid cells with dispersed chromatin and inconspicuous nucleoli admixed with eosinophils (arrows) (C-2A, H&E, 400x). Immunohistochemical stains showed the neoplastic lymphoid cells were positive for membranous CD1a (C-2B), nuclear TdT (C-2C), and cytoplasmic CD3 (C-2D), immunohistochemical stain, 400x.
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TdT (Figs.C-2B-D). The case was diagnosed as T-cell LBL.
A: -B: RT-PCR showed amplification product from the ZNF198-FGFR1 fusion gene in duplicate of patient's lymph node specimen (lower image). The RNA quality was shown to be adequate (top image). Neg ctrol indicates no template control; pos ctrol indicates presence of ZNF198-FGFR1 chimeric fusion with the same size of patient's amplicons (C-3A). Dideoxynucleotide sequencing analyses of the RT-PCR product demonstrated the presence of a ZNF198-FGFR1 chimeric transcript (C-3B).
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