PMC8285057_01
PET/CT images at different time points during treatment. (A) At the time of diagnosis, PET/CT revealed the lymphadenopathy in the mediastinum, left axilla, peritoneal retroperitoneal, bilateral diaphragmatic foot, and left peri-iliac vessels; as well as several nodular FDG-avid lesions in the right scapula with hypermetabolic activity (SUVmax: 7.9). (B) After four cycles of GemOx plus tislelizumab combination treatment, PET/CT revealed that patient achieved complete response.
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Positron emission tomography/computed tomography (PET/CT) revealed the involvement of multiple lymph nodes in both sides of the diaphragm and scapula ( Figure 1A ). We performed PET/CT after 4 cycles of the combined regimen therapy, and the results showed that the tumor had disappeared completely ( Figure 1B ).
Pathological immunohistochemistry of abdominal lymph node puncture. (A) H&E staining revealed the abnormal cell proliferation with lamellar necrosis in the abdominal lymph node biopsy tissue (100x manifestation). (B) H&E staining revealed the abnormal cells with large cell volume, abundant cytoplasm, irregular nuclei, thick nuclear chromatin and few visible nucleoli (200x manifestation). (C-J) Immunohistochemical staining showed that lymphoma cells were positive for (C) CD3, (D) CD8, (E) TIA-1 and (F) Ki-67 (approximately 90%), but were negative for (G) CD56, (H) CD4, (I) CD5, (J) CD30 and (K) CD20. (L) EBV-encoded RNA (EBER) in situ hybridization revealed the positive EBV infection.
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Abdominal lymph node biopsy specimen showed large areas of tissue necrosis, focal distribution of abnormal cells with large cell volume, abundant cytoplasm, irregular nuclei, thick nuclear chromatin, and few visible nucleoli under a pathological microscope ( Figures 2A, B ). T-cell intracellular antigen 1 (TIA-1), and granzyme-B (GrB), while were negative for CD4, CD5, CD56, CD30, CD20, and PAX-5 ( Figures 2C-K ). The Ki-67 index was approximately 90% ( Figure 2F ). EBV-encoded RNA (EBER) in situ hybridization revealed the positive EBV infection ( Figure 2L ), and a polymerase chain reaction (PCR) detected the plasma EBV-DNA titer of 9.65x104 IU/ml (reference range, <5x102 IU/ml).