PMC7361477_01
(A) Computed tomography scan of left shoulder showing lytic lesion along the coracoid of the scapula. (B) Magnetic resonance imaging of left shoulder showing abnormal marrow signal within coracoid process of scapula. (C and D) Bone scan showing increased activity in left shoulder region.
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Computed tomography scan of the left shoulder with contrast demonstrated a 10 x 8 mm lytic lesion along the coracoid of the scapula with enlarged left axillary lymph nodes (Figure 1A). The patient eventually got magnetic resonance imaging of left shoulder, which demonstrated abnormal marrow signal within the coracoid process of the scapula, with a cortical disruption, periosteal reaction, and multiple foci of enhancement within the humerus with no evidence of rotator cuff tear (Figure 1B).
(A) Hematoxylin and eosin stain slide showing tumor characteristic. (B) CD15-positive tumor cells consistent with classic Hodgkin's lymphoma (cHL). (C) CD20-positive tumor cells consistent with diffuse large B-cell lymphoma (DLCBL). (D) CD30-positive tumor cells consistent with cHL. (E) CD79a-positive tumor cells consistent with DLCBL. (F) MUM1-positive tumor cells consistent with cHL.
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D). During hospitalization, the patient had a bone biopsy by interventional radiology with histopathology and immunophenotype (Figure 2A-F) showing atypical intertrabecular lymphohistiocytic infiltrate containing small and large lymphocytes in the background of necrosis.