PMC8437410_01
The pleural fluid contained numerous large atypical lymphocytes on the cytospin slide ((A) Giemsa and Wright stain, x 50) and cell block ((B) Hematoxylin and eosin stain, x 40). Immunohistochemistry studies showed the lymphocytes were positive for PAX 5, CD20, BCL2, BCL6, MUM1 (weak) with a high proliferative rate by Ki-67 90% ((C-H) x 20).
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The Ki-67 proliferation index was high at >90% (Figure 1C-H).
PET scan demonstrated no abnormal FDG processes throughout the body. Large right-sided pleural effusion was present, but without any hypermetabolic activity (arrows).
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Full-body positron emission tomography (PET) scan further demonstrated no evidence for any fluorodeoxyglucose (FDG) avid process (Figure 2).