PMC10189153_01
Contrast-enhanced CT scan demonstrated a 7.4 x 4.9 cm2 heterogeneous mass in the anterior mediastinum, where a large area cystic liquid existed, and multiple enlarged lymph nodes in the mediastinum (A,B); The whole mass, invaded tissues and adjacent enlarged lymph nodes were removed completely (C,D). CT, computed tomography.
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F1
Contrast-enhanced computed tomography (CT) scan demonstrated a 7.4 cm x 4.9 cm heterogeneous mass in the anterior mediastinum, where a large area of cystic liquid existed, and multiple enlarged lymph nodes in the mediastinum (Figure 1). The whole mass invaded tissues, and adjacent enlarged lymph nodes were eradicated (Figure 1).
The test of beta2 MG (A) and EBV-DNA (B) showed that they were less than the standard limit in half a year follow-up.
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F2
Meanwhile, EBV-DNA was less than 400 copies/ml (reference range <400 copies/ml), and beta2 MG was 1.9 mg/l (reference range 1.0-3.0 mg/l) (Figure 2). The test of EBV-DNA, beta2 MG (Figure 2), and CT (Figure 6) showed they were less than the standard limit in half a year follow-up.
H&E staining and immunohistochemistry pictures of the mass (x400). In this part, H&E staining picture revealed a diffuse infiltration of tumor cells that were rich in plasma and possessed vesicular chromatin accompanied prominent nucleoli (A). The tumor tissue strongly expressed CD3 (B), PD-1 (C), and CD21(E), but was negative for CD20 (D). Those were considered angioimmunoblastic T-cell lymphomas.
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F3
There were two morphologically and immunophenotypically distinct components-T- and B-cell mixed hyperplasia (Figure 3 and 4). Immunophenotypic analyses showed the lymphocytes were CD5+, CD3+, CD10 (partial +), PD1+, CD43+, BcL2+, CD21 and CD23 (FDC net irregular hyperplasia), MUM1-, CD30+ (scattered in large cells), TdT-, CD56-, PCK+ (thymic epithelium), CD15-, CyclinD1-, Bcl6-, IgD-, Kappa-, Lambda-, CD20+ and PAX5+ (B cells), and CD43+ (diffuse, B cells with abnormal expression) (Figure 3 and 4).
H&E staining and immunohistochemistry pictures of the mass (x400). In this part, H&E staining picture revealed a diffuse infiltration of tumor cells that were rich in plasma, and possessed vesicular chromatin accompanied prominent nucleoli (A). The tumor tissue strongly expressed CD20 (C) and CD43 (D), but was negative for CD3 (B) and PD-1 (E) Those were considered B-cell lymphomas.
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F4
There were two morphologically and immunophenotypically distinct components-T- and B-cell mixed hyperplasia (Figure 3 and 4). Immunophenotypic analyses showed the lymphocytes were CD5+, CD3+, CD10 (partial +), PD1+, CD43+, BcL2+, CD21 and CD23 (FDC net irregular hyperplasia), MUM1-, CD30+ (scattered in large cells), TdT-, CD56-, PCK+ (thymic epithelium), CD15-, CyclinD1-, Bcl6-, IgD-, Kappa-, Lambda-, CD20+ and PAX5+ (B cells), and CD43+ (diffuse, B cells with abnormal expression) (Figure 3 and 4).
Gene rearrangement test revealednot IGH, IGK, and IGL (A), but TCRgamma, TCRdelta and TCRbeta (B) cloning rearrangement.
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F5
Gene rearrangement test revealed TCRG and TCRB, but not IGH, IGK, or IGL, cloning rearrangement (Figure 5).
CT in the 1-month follow-up (A,B); CT in the 7-month follow-up (C,D). CT, computed tomography.
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F6
The test of EBV-DNA, beta2 MG (Figure 2), and CT (Figure 6) showed they were less than the standard limit in half a year follow-up.