34y.female. During two month fatigue, fever, dyspnoe, cough, pain in the left part of thorax.
Objective: enlargment of lymph nodes in left supraclavicular, neck and axillar regions.
CT: Nodular tumor, predominantly in upper part of mediastinum(8,5 x 12,5 x 11,0), with continual spread to supraclavicular and neck regions. Involvement of left pumonary hilus, compression of blood vessels and bronhci, bilateral hilar lymph node enlargement and fluidothorax (cyt: eosinophilia, no ly-ma elements).
Blood values normal, sligth lymphopenia.
Clinical chemistry normal;
HIV neg; EBV is not performed.
Supraclavicular lymphnode(2,2x1,3)investigated:
Ln is obliterated with nodules and sheets of large,LCA/ALK/CK- and partly CD20/30/15/EMA+, pleomorphic,highly atypical neoplastic lacunar cells, admixed with variable amount of irregularly arranged fibrotic bands and blood vessels.
Clonality investigations(PCR)are performed, results are not available up to present.