PMC4246138_01
(a) High power view of Level 7 lymph node from the neck showing atypical cells, some of which are multinucleated and consistent with Reed-Sternberg (RS) cells although not typical. (b) Immunohistochemical stain showing RS cells positive for CD30.
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Two weeks prior to the presentation, the patient was diagnosed with nodular sclerosing Hodgkin's lymphoma (Fig. 1a and b) stage IV on her lymph node and bone marrow biopsy.
Graph showing deterioration of coagulation parameters.
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A liver biopsy was withheld due to significant thrombocytopenia, coagulopathy (Fig. 2), and encephalopathy.
(a) Liver biopsy showing diffuse infiltration of liver by lymphoma cells with disruption of hepatic architecture and necrosis. (b) Liver biopsy showing hepatocellular necrosis and malignant infiltrate of lymphoma cells.
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The pathologic examination of the liver showed small nodules of cancer as well as infiltrative neoplastic pattern characterized by areas of necrosis, characteristic Reed-Sternberg cells, and areas of hypocellularity in an eosinophilic fibrillar background (Fig. 3a and b).