PMC5317071_01
Maximum Intensity Projection (MIP) image of FDG PET/CT scan showing intense uptake in axial as well as appendicular skeleton, which appears focal and patchy at some sites B, Fused 18 F-FDG PET/CT transaxial image showing intense tracer uptake in multiple thyroid nodules in an enlarged thyroid gland.
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F1
Also noted were FDG avid lesions in skull, cervical, dorso-lumbar vertebrae, sternum, ribs, bilateral pelvic bones, humerus, and femur. [Figure 1A and B].
Cellular thyroid aspirate comprising intermediate to large sized atypical lymphoid cells with scant cytoplasm and fine chromatin (Giemsa stain A, 20x B, 40x)
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F2
A cytological impression of high grade non Hodgkin lymphoma (NHL) involving the thyroid gland was offered. [Figure 2A and B].
Bone marrow biopsy showing A, hypercellular marrow with near total replacement of hematopoietic cells by leukemic cells (H and E 200x) B, CD 20 C, Tdtimmunopositivity (200x) Flow cytometry showing leukemic cells positive for D, CD 34 E, CD79a F, cMPO
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F3
Thyroid Biopsy showing A, infiltration of thyroid parenchyma by leukemic cells (H and E, 200x) B, CD 34 C, CD 20 D, CD 43 immunopositivity (200x)
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F4