CASE IS OPEN:  
"SURGICAL" ABDOMINAL PATIENT (NO DATA ABOUT HEMATO TO DATE):  
43 yrs old female with visceral lymphadenopathy: regional lymphonodectomy was performed, thinking about tumor in largest node.  
CLINICAL: ~3cm "tumor" from mesocolon, between v.cava inf. and duodenum (GIST vs Sa?).  
MACRO: 3x2,4x2,5 cm firm, whote/yellowish node and smaller lymph node (NOT INCLUDED THERE).  
 
HISTO: Interfollicular/internodular massive storiform sclerosis with voluminous foci. No amyloid deposits. Nodules like I follicles (with admixture CD23+ cells, dendritic networks), II follicles practically absent. The small calcificates present. Cytology: small medium lymphos with slightly irregular nuclei.  
 
IH: No definite abberancies present (CD20+ slightly heterogenous; p27+; CD23/CD21/CD35+ (focal); Bcl2+; CD5/CyclinD1/CD10/Bcl6/MNDA1(-); IgM+ > IgD+ > IgG+); Ki67 index low <5%.  
 
MOLECULAR: B and T non-clonal. MYD88 mutation absent.  
 
PROPOSAL: Atypical lymphadenopathy (IgL not- monotypic) with storiform fibrosis and some "castleman/oid" features:  
- Autoimmune diseases (Lupus? other?);  
- B marginal zone lymphoma possible vs other (B SLL/CLL? other?).  
 
 
ThankYouForBeeingTogether.

tzankov 2018-03-31 19:39	can you please add an image of the IgD and Bcl6 stainings? have you considered an IgG4 disease?
ugnius 2018-04-01 11:03	Thanx. No IgG 4 cells. Follicles not gcb. I will proceed in Tuesday. Preliniminary reccomendation to sent to Hema, cause onco-dept cannot provide add info...
ugnius 2018-04-05 11:24	IgD and molecs are placed in.