PMC9909044_01
The appearance of an erythematous maculopapular rash in the patient's limbs: (a) bilateral lower limbs and (b) right thigh.
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The skin eruption recurred 3 days later, and a punch skin biopsy showed minimal superficial dermal perivascular lymphocytic cell infiltrate consistent with perivascular interface dermatitis, a possible morbilliform drug eruption (Figure 1).
Computer tomography scan of the neck showing bilateral sub-centimeter cervical lymph nodes, some of them showed central necrosis.
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Computer tomography of the neck revealed bilateral sub-centimeter cervical lymph nodes; some lymph nodes showed central necrosis (Figure 2).
Lymph node histopathology showing histiocytes, lymphocytes, scattered eosinophils, karyorrhexis, and apoptotic bodies in a necrotic background with diffuse and strong positive CD68.
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Moreover, lymph node histopathology showed partially effaced lymph nodes composed of histiocytes, lymphocytes, scattered eosinophils, karyorrhexis, and apoptotic bodies in a necrotic background with immunohistochemistry diffuse and strongly positive for CD68 (Figure 3).
Bone marrow biopsy showing hemophagocyte in the center of the slide with different view (a-c) blue arrows. Histiocytes seen in the mid of the slide (d) green arrow.
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Limited flow cytometry showed 14% lymphocytes with 70% T cells (positive CD2, CD3, CD5, CD7, CD8), 25% B cells (CD19), and NK-cell of 5% (CD5-/CD19-) (Figure 4).