CONSULTATION CASE/ EXTERNAL PARAFIN BLOCKS/ LOW QUALITY.
HISTORY:49 yrs old male with lymphadenopathy in the neck slowly growing for 2 yrs. Any B symptoms are present. Lymph node biopsy (5,3cm) was performed.
HISTO: Nodular and diffuse LH infiltrate with scattered giant cells with lobulated nuclei. Multifocal central "clearing" in nodules (floret like).
IMMUNO: atypical lobated/iregularly nucleated cells with large nucleoli in "floret" nodules: CD30-CD15+EMA+CD20+ Bcl2-Mum1-Bc6+; There are identical scattered cells in diffuse histyocyte reach areas, but CD15-/+CD30-EMA-CD20+. CD21+ prominent FDC network in the nodules, but CD23+ only single groups of FDC. CD57 accentuation in the nodules with peritumoral rosetting.
SCHEME: Blue- rudimentary follicles, dotted blue- tumor nodules, pink- diffuse histyocyte reach areas.
QUEST: NLP HL with CD20+CD30-CD15 immunophenotype? Why tumor cells in the diffuse areas are slightly IH different: CD15/EMA loosing (TcrB transformation possibility? Underfixation/underprocessing in eosinophilic/diffuse areas?).
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