Presentation
Incidental finding of lymphadenopathy
Patient Data
Age: 80 year-old
Gender: Male
From the case:
Hodgkin Lymphoma
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There is intense FDG activity associated supra and
Case Discussion
This patient initially presented to our Urology Stone Clinic with left sided renal colic. He had a CT KUB done which showed a 8mm proximal left ureteric calculus with incidental finding of widespread intra-abdominal lymphadenopathy.
He went on to have a FDG-PET scan which confirmed multiple intense FDG avid lymph nodes both supra and infra-diaphragmatically.
He proceeded to have a US guided biopsy of left axillary lymph node which confirmed Hodgkin lymphoma.
Histopathology findings:
- MACROSCOPIC: Axillary node right, three cores ranging in size from 7 mm up to 17 mm.
- MICROSCOPIC: Sections show cores of lymph node with effaced nodal architecture. There is fibrosis and a mixed lymphoid infiltrate including eosinophils, small lymphocytes and histiocytes. Within the mixed lymphoid infiltrate there are singly disbursed large atypical cells with morphology consistent with HRS cells.
- IMMUNOHISTOCHEMISRTY: Immunohistochemistry shows the large atypical cells to be CD30 +, CD20 -, PAX5 -, OCT2 and BOB1 scattered weak + cells, CD3 -, CD5 -, CD2 -, CD7 -. There are scant remnants of FDC meshwork seen on CD21. EBER-ISH -, ALK1 -.
- SUMMARY: Consistent with classic Hodgkin lymphoma.
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