PMC5615981_01
(a, b, c) Diagnostic axial FDG-PET images illustrate FDG-avid axillary, mediastinal, and cervical nodes, respectively. (c, d, f) Posttreatment axial PDG-PET images illustrate no FDG-avid evidence of residual disease at cervical, mediastinal, and axillary nodes, respectively.
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fig1
A fluorodeoxyglucose-PET-CT (FDG-PET-CT) was performed to localise the paraprotein-producing tumour, demonstrating bilateral FDG-avid cervical and axillary nodes, with a single mediastinal and portacaval node (Figures 1(a), 1(b), and 1(c)). Myeloma Working Group (IMWG) criteria. Moreover, repeat FDG-PET-CT following 4 cycles of treatment showed a complete response (Figures 1(d), 1(e), and 1(f)).
Left axillary lymph node biopsy. (a) Haematoxylin and eosin stain at x40. (b) CD138 stain at x40, strongly positive. (c) Kappa stain at x40, strongly positive. (d) Lambda stain at x40, negative demonstrating kappa light chain restriction.
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fig2
The largest axillary node (7 mm) was biopsied revealing replacement of the nodal architecture by a CD138 positive, kappa-restricted plasma cell infiltrate (Figure 2).