PMC3415761_01
Computed tomography of the cervical region. A. Initial scan showing lower left carotid-jugular cervical lymphadenomegaly (Grade IV) of up to 25mm (largest diameter); B. Scan at 7 months of clinical follow-up showing lymphadenomegaly of up to 17 mm/caption
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F1
Diffuse medullary hyperplasia was observed on the myelography, whereas cervical computed tomography (CT) demonstrated submandibular lymphadenomegaly on the right measuring 12 x 9 mm and on the left (Grade II, III, IV and V) measuring up to 25 x 16 mm, which was suggestive of lymphoma (Figure 1). Seven months later, CT scans confirmed clinical findings of significant reductions in lesion size (Figure 1B).
Histological sections of excised lymph node showing increased volume. A. Histiocyte containing numerous lymphocytes (emperipolesis) (hematoxylin and eosin at 400x magnification); B. Immunohistochemical staining for protein S100 expression (400x magnification)
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F2
The less affected parts of the lymph node displayed prominent reactive lymphoid follicles with medullary substance containing plasmocytes, mature lymphocytes and foamy cell aggregates (Figure 2A). The immunohistochemical examination was positive for PS100, CD68, CD45 and CD31 and negative for CD1a, thus compatible with RDD (Figure 2B).