PMC4720080_01
Result of bone marrow examination showed slightly increased foamy histiocytosis (H&E staining, x200).
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Bone marrow examination showed cellularity of 60%, which was slightly hypercellular for the patient's age, with slightly increased foamy histiocytosis (Fig. 1).
Magnetic resonance imaging of the spine showed compression fractures of the T5 (A), L3, and L4 (B) vertebral bodies on a T1-weighted image. Involvement of the metaphysis and diaphysis, with relative sparing of the epiphysis, was observed.
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Compression fractures of the T5, L3, and L4 vertebral bodies were identified by magnetic resonance imaging of the spine (Fig. 2A and B).
(A, B) Compression fractures were observed by a computed tomography scan of the patient's chest at T5, T7-8, T12, and L3-4 spines. (C) In addition, computed tomography imaging identified cardiomegaly and multiple prominent lymph nodes in both axillae. (D) Irregular sclerotic change was observed in both femur necks.
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Irregular sclerotic change was observed in both femur necks (Fig. 3).
Histopathological examination of axillary lymph nodes revealed diffuse infiltration of lipid-laden histiocytes (A, H&E staining, x200; B, H&E staining, x400).
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Axillary lymph node biopsy revealed diffuse infiltration of lipid-laden histiocytes (Fig. 4), which were found to be positive for CD68 and negative for S100 and CD1a.
Immunohistochemical examination of the previous bone marrow biopsy in March 2009 showed that the infiltrating histiocytes were positive for CD68 (A) and negative for S100, CD1a (B, C), and BRAF (D).
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Immunohistochemical stain of the bone marrow biopsy examined in March 2009 showed that the infiltrating histiocytes were positive for CD68 (Fig. 5A) and negative for S100, CD1a (Fig. 5B and C), and BRAF (Fig. 5D).