PMC6232806_01
PET/CT with an infiltrative mass in the mediastinum with diffuse uptake.
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Due to concern for lymphoma and findings on CT of the chest, a PET/CT was ordered which showed an infiltrative mass in the mediastinum with diffuse uptake (maximum standardized uptake value (SUV) 5.94 (Figure 1).
PET CT with hypermetabolic mass within the left iliac bone.
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Finally, there was a hypermetabolic mass within the left iliac bone with a maximum SUV 11.71 (Figure 2).
Hematoxylin and eosin stain: lymphoid tissue composed of small, mitotically inactive cells with round to slightly irregular nuclear contours and scant cytoplasm.
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Immunohistochemistry positive for CD20.
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Immunohistochemical stains showed that the cells were positive for CD20 (Figure 4) and CD5 (Figure 5) and negative for Cyclin D1 (Figure 6).
Immunohistochemistry positive for CD5.
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Immunohistochemical stains showed that the cells were positive for CD20 (Figure 4) and CD5 (Figure 5) and negative for Cyclin D1 (Figure 6).
Immunohistochemistry negative for Cyclin D1.
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Immunohistochemical stains showed that the cells were positive for CD20 (Figure 4) and CD5 (Figure 5) and negative for Cyclin D1 (Figure 6).
Hematoxylin and eosin stain: a malignant infiltrate of small, mitotically inactive lymphocytes replacing the marrow space in the biopsy from left iliac bone.
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PET avid left iliac bone. Pathology from that biopsy showed both bone and marrow with involvement of CLL/SLL (Figure 7).
Flow cytometry from the left iliac bone biopsy revealed monoclonal kappa light chain restricted B-cell population phenotypically consistent with CLL/SLL.
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