PMC9550423_01
(a) Lymph node specimen from this case; the nodular pattern was observed (x2). (b) Tumor cells were positive for BCL2 (x4).
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September 2016. She was diagnosed with follicular lymphoma grade 1 by biopsy of cervical lymphadenopathy (Figures 1(a) and 1(b)).
Bone marrow specimens in 2021: (a) atypical plasma cells with lymphocytes (x20). (b) Both lymphocytes and plasma cells are BCL2-positive (x20). Bone marrow specimens in 2016: (c) lymphocytes and plasma cells are observed (x20). (d) Plasma cells. Both cells and lymphocytes are BCL2-positive (x20).
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Furthermore, infiltration of B lymphocytes, nuclear enlargement, and 12.2% of multinucleated plasma cells were observed (Figure 2(a)). Both lymphocytes and plasma cells were found to be BCL2-positive by immunostaining (Figure 2(b)). The bone marrow specimen in 2016 was restained, and both lymphocytes and plasma cells were also found to be BCL2-positive (Figures 2(c) and 2(d)).
Bone marrow specimens in 2021: (a) CD3-positive T-cells around the myeloma cells (x40). (b) CD4-positive T-cells around the myeloma cells did not increase in number (x40). (c) CD8-positive T-cells around the myeloma cells (x40).
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These T-cells were mostly CD8-positive T-cells, wherein CD4-positive cells did not increase in number (Figures 3(a)-3(c)).