PMC3114563_01
PMC3114563_02
Flow cytometry of the bone marrow and peripheral blood of patient 2, showing a monoclonal TCR Vbeta13.2 T-cell population, CD3+, TCRalphabeta+, CD8+, CD7+, CD30+, EMA+, ALK-, of high mitotic index (Ki-67 = 40%).
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fig1
It revealed a restricted expansion of TCRVb13.2 region, but was also highly mitotic (Ki-67 = 40%), ki-1/CD30+, EMA+, and ALK- (Figure 1).
PMC3114563_03
Flow cytometry of sample from the lymph node of patient 3. The coexpression of CD30 and CD71, in a CD45 and CD3 positive population of high forward scatter characteristics, indicated the possibility of Hodgkin and Reed Sternberg (HRS) cells, based on T cell rosetting around HRS cells. This composite immunophenotype (CD45+/CD30+/CD71+/CD3+/CD20-) (gate HD) was considered due to contributions by the HRS cells and the surrounding T cells.
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fig2
Classical HL was suggested by the lymph node findings, because of the composite immunophenotype CD45+/CD30+/CD71+/CD3+/CD20-, in a high forward-scattered cell population (Figure 2), with CD15dim expression.
Microscopy of pleural effusion specimen from patient 3 showing Hodgkin-like cells, surrounded by atypical lymphocytes, probably T-cells (HRS-cell-T-cell rosette).
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fig3
The FC conclusions were based also on the morphological suspicion of Hodgkin and RS (HRS) cells, particularly in the pleural effusion (Figure 3).