PMC9578959_01
Infiltration of monomorphic small lymphoid cells in an inguinal lymph node biopsied at the first onset of disease. (A) H&E staining image (20x) showing that the tumor cells had high nucleus-to-cytoplasm ratios and condensed chromatin. Immunohistochemistry images showing that the abnormal cells were positive for CD20 (B), CD5 (C), and CD23 (D).
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BCL-2 but immunonegative for CD10, CD3, and Cyclin D1, with 15%+ Ki67 (Figure 1). Bone marrow biopsy showed infiltration by monoclonal B lymphocytes, and a diagnosis of small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL) was made.
Distribution of abnormal large cells with partial nuclear deviation based on the core needle biopsy of the enlarged left neck mass 1 year after first diagnosis. (A) H&E staining image (20x) showing that these cells were pleomorphic with bent nuclei, pale chromatin, and prominent nucleoli. Immunohistochemistry images showing that the abnormal cells were positive for CD30 (B), CD4 (C), and ALK1 (D).
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These findings were consistent with ALK-positive anaplastic large-cell lymphoma (ALCL; Figure 2).