PMC3572776_01
Histologic appearance of the lymph node biopsy of patient #1. (A) Lymph node showing marked architectural effacement by marginal zone cells expansion (continuous arrow) and residual follicles (dashed arrow) (H&E, 40x). (B) PTGC-like changes seen in the expanded residual follicles (H&E, 40x). (C) Close up of the marginal zone infiltrate showing mostly small to medium size cells with slightly irregular nuclei and scant cytoplasm. Residual germinal centers are noted with attenuated mantle zone and evidence of colonization by the atypical cells (arrow) (H&E, 100x and 400x insert). (D) Flow cytometry showing a monotypic lambda light chain subpopulation of B cells (circled population; gating on larger lymphocytes). X axis represents staining with anti-human lambda light chain monoclonal antibody and Y axis represents staining with anti-human CD19 monoclonal antibody.
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F1
He underwent excisional lymph node biopsy that showed total effacement of the lymph node architecture by an atypical proliferation of lymphocytes with marked marginal zone expansion resembling progressive transformation of germinal centers (PTGC) (Fig 1).
PMC3572776_02