PMC8262163_01
MRI (Magnetic Resonance Imaging) (A) at the moment of first presentation, depicting a volume of 28 mm x 29 mm x 42 mm (AP x ML x CC) and (B) 5.5 months later, after an incision biopsy was performed. Aa, This T2 weighted image depicts a well-described, mass of intermediate intensity at the buccinator space. Ba, T2 weighted image depicting the absence of the lesion, indicative for tumor remission. Ab, T1 weighted image with Gadolinium contrast, showing expansion to the infraorbital region. Contrastcaptation is moderate. Bb, T1 weighted image depicting the absence of the lesion.
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F1
Consecutively, an ultrasound and a Magnetic Resonance Imaging (MRI) scan (Figure 1A) of the head and neck were performed. As the infraorbital hypo-aesthesia persisted, further imaging was ordered which revealed a complete and spontaneous remission of the tumor mass (5.5 months after the initial MRI) (Figure 1B).
Biopsy. The mass presented as a well-described, encapsulated lesion.
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F2
During this procedure, a well-described, encapsulated mass was encountered (Figure 2).
Lymph node biopsy, showing a follicular lymphoma with brisk TFH response and BCL2-rearrangement. (A) low power view showing a disturbed lymph node architecture, with numerous small follicles arranged in a back-to-back fashion. (B). The follicle centers are composed predominantly of small centrocytes and scattered centroblasts (less than 15/high power field), in the absence of tangible body macrophages. The B-cells in de follicles express CD10 (C), BCL6 (D), overexpress BCL2 (E) and are intermingled with numerous follicular T-helper cells, as illustrated by a immunostaining against PD1 (F). (G) FISH highlights the presence of a BCL2-rearrangement, corresponding to the BCL2 overexpression in the follicles, as illustrated in the anti-BCL2 immunostain (E) (scale bar: 100 microm).
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F3
It showed a disturbed lymph node architecture, with vague nodules organized in a back-to-back manner (Figure 3).