Female patient, 36 years old was diagnosed in 2013 with Hodgkin's disease (pathology + IHC). She had complaints on enlargement of neck LN. CT showed enlargement of neck LN up to 20 mm, mediastinal LN up to 70 mm and multiple lung lesions up to 15 mm. She recieved 8 BEACOPP-base + 2 ABVD + radiation therapy. Patient achieved partial response in October 2014 (Residual mass in mediastinum and fibrotic changes in lungs).

Enlargement of lesions in lung was revealed on planned CT in September 2015. Patient underwent PET/CT on September, 24th 2015, that showed active metabolic changes in lung. Biopsy of the biggest lesion in lung was done in October 2015. Pathology + ICH showed Primary mediastinal B-cell lymphoma. Our laboratory reviewed primary biopsy material and also confirmed non-Hodgkin's lymphoma. 

Pictures show two H&E staining of primary biopsy material and H&E + ICH of relapse biopsy material.