PMC6389009_01
Computed tomography (CT) and fluorodeoxyglucose positron-emission tomography (FDG-PET) scans.. Notes: (A) CT performed before rituximab-idelalisib treatment initiation, showing a large left cervical lymph node conglomerate extending from upper jugulocarotid territory to left supraclavicular territory, sheathing the jugulocarotid vascular system, lymph-node invasion of the left parotid lodge, and multiple left supraclavicular adenopathies. (B) FDG-PET performed after 3 weeks of rituximab-idelalisib treatment, revealing the absence of lymph-node hypermetabolism in the cervical region associated with the presence of several inflammatory hypermetabolic mediastinal lymph nodes supporting a complete response. Complete response was maintained and confirmed by FDG-PET performed at 3 months (C) and 6 months (D) after treatment initiation.
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CR after only 3 weeks of rituximab-idelalisib treatment (Figure 1B). CR was maintained and confirmed on FDG-PET performed at 3 months and 6 months after treatment initiation (Figure 1C and D).
Histological examination of a cervical lymph node, revealing the transformation of SLL into a DLBCL with an ABC phenotype.. Notes: (A) HES staining, OM 1.1x, showing lymph node and periganglionic infiltration. (B) HES staining, OM 39.1x, showing infiltration with large cells with a large nucleus, containing a large nucleolus and some images of mitosis. (C) CD20 immunostaining, OM 19.6x. (D) Ki67 immunostaining, OM 40.7x, showing an index of proliferation at 40%.. Abbreviations: SLL, small lymphocytic lymphoma; DLBCL, diffuse large B-cell lymphoma; ABC, activated B cell; HES, hematoxylin-eosin-saffron; OM, original magnification.
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CD20+, BCL2+, CD10-, BCL6-) and a Ki67 index of proliferation of 40% (Figure 2). Cytogenetic analysis of the lymph node revealed an abnormal clone with a 10p deletion (46,XY,del[10][p11][6]/46,XY[12]).