Presentation
Facial lump
Patient Data
Well-circumscribed enhancing nodule/node arising from the tail of the right parotid gland.
The nodule/node demonstrates a low ADC value (approximately 650 x 10-3
No other abnormal lymph node in the neck.
No pharyngeal mass.
18G core biopsy of the parotid lesion has been performed under US guidance.
Case Discussion
CLINICAL NOTES. Right inferior parotid mass; specimen received fresh and split for flow cytometry
MICROSCOPIC EXAMINATION. The sections show a lymph node with partially effaced architecture. There is a nodule composed of sheets of mainly small lymphocytes. There are readily identifiable lymphocyte predominant (LP)/ popcorn cells. These are larger than background lymphocytes. They are scattered within this nodular area. They have large irregular convoluted nuclei with prominent nucleoli. Rare reniform ones are also identified. Immunohistochemistry shows that the LP cells express PAX 5 (weak), CD 20 (strong), OCT 2, BOB 1, CD 79a and BCL 6. OCT 2 and BOB 1 coexpression is noted. CD15 and CD30 are negative. CD30 is positive in background reactive immunoblasts. CD3, EMA and EBER/ EBV ISH are negative within the LP cells. There is tight rosetting around the LP cells by CD3-positive cells. The features are consistent with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL).
CONCLUSION. RIGHT PAROTID: NODULAR LYMPHOCYTE PREDOMINANT HODGKIN LYMPHOMA (NLPHL).
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