PMC7762437_01
Pathological features: heteromorphic large lymphocyte proliferation, HE staining, magnification, 400x.
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The pathological results revealed the proliferation of large lymphocytes (Figure 1).
Immunohistochemical stains: CD20 (+++), CD79a (+++), CD3(-), BCL-2(-), BCL-6(+), CD10(-), MUM-1(+), Ki-67(+>90%) (HE staining, 200x), and CD30 scattered positive (HE staining, magnification, 400x).
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Immunohistochemical markers present included heteromorphic large lymphocytes CD20 (+++), CD79a (+++), CD3(-), BCL-2(-), BCL-6(+), CD10(-), MUM-1(+), Ki-67(+>90%), and CD30 scattered positive (Figure 2).
PET/CT scan results before chemotherapy: multiple hypermetabolic lymph nodes along bilateral inguinal regions (A) and external iliac vessels (B). The red arrow points to hypermetabolic lymph nodes.
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PET/CT examination showed multiple hypermetabolic lymph nodes next to the external iliac vessels and bilateral inguinal regions (Figure 3), which were consistent with the changes in lymphoma infiltration changes.
In-situ hybridization for Epstein-Barr virus-encoded RNA is scattered positive, HE staining, magnification, 400x.
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In-situ hybridization for Epstein-Barr virus-encoded RNA was scattered positive (Figure 4).
PET/CT scan results after the 4th chemotherapy: slightly larger lymph nodes lacking significant metabolic increases along the inguinal regions (A) and the external iliac vessels (B). The red arrow points to slightly larger lymph nodes.
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After 4 cycles of chemotherapy, re-examination by PET-CT showed no signs of recurrence of the hypermetabolic tumors after chemotherapy for vulvar lymphoma, and signs of slightly larger lymph nodes along the external iliac vessels and inguinal regions, without significant metabolism increases (Figure 5).
PET/CT scan results six months later after completing 8 chemotherapy courses: No signs of tumor recurrences along bilateral inguinal regions (A) or external iliac vessels (B).
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Re-examination by PET-CT showed no obvious signs of tumor recurrence six months later after completing 8 chemotherapy courses (Figure 6).