Case 4
-
Upload
kciapm -
Category
Health & Medicine
-
view
42 -
download
5
Transcript of Case 4
![Page 1: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/1.jpg)
Case 4
28y/F , presented B/L cervical lymphnodes of 1 – 4cm. in size of 6months duration. FNA of lymphnodes done
![Page 2: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/2.jpg)
![Page 3: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/3.jpg)
![Page 4: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/4.jpg)
![Page 5: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/5.jpg)
![Page 6: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/6.jpg)
![Page 7: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/7.jpg)
![Page 8: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/8.jpg)
![Page 9: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/9.jpg)
![Page 10: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/10.jpg)
![Page 11: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/11.jpg)
![Page 12: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/12.jpg)
![Page 13: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/13.jpg)
Cytology: Cellular smear,
Lymphoid cells, histiocytes/macrophages,
A few large cells with mono/binucleate, with prominent nucleoli, ?RS cells
Numerous eosinophils, occ. Plasma cells
![Page 14: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/14.jpg)
DIAGNOSIS
![Page 15: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/15.jpg)
Case 4
1. Histoplasmosis, Kimura’s Disease2. Lymphoproliferative Diease3. HD – Mixed Cellularaity4. LCH5. HD – Lypmphocytic Predominance6. SHML with Eo7. SHML with LCH8. Kimura’s disease
![Page 16: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/16.jpg)
IMP: Positive Malignancy – 1. Malignant lymphoma, HD/ALCL 2. Metastatic Undifferentiated Carcinoma Case will be reviewed after H & N workup H & N workup was normal FINAL IMP: 1. Malignant lymphoma, HD/ALCL 2. Histiocytic Lesion Advised LN Bx and IHC study
![Page 17: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/17.jpg)
![Page 18: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/18.jpg)
![Page 19: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/19.jpg)
![Page 20: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/20.jpg)
CD1a
![Page 21: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/21.jpg)
S100
![Page 22: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/22.jpg)
CD30
CD15
CD30
![Page 23: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/23.jpg)
CD15
![Page 24: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/24.jpg)
Final diagnosis
Hodgkin Lymphoma-syncial type with LCH
![Page 25: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/25.jpg)
Diagnosis of Hodgkin Lymphoma
Diagnosis of LCH
![Page 26: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/26.jpg)
LCH – Systemic or single organ disease lung, bone, lymphnode, skin, etc.
Cytology findings
Histomorphology –sinusoidal pattern + IHC
LCH+Lymphoma – Focal Langerhan Cell Histiocytic Hyperplasia rather than LCH
![Page 27: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/27.jpg)
J Res Med Sci. 2010 Jan-Feb; 15(1): 58–61.
Langerhans cell histiocytosis following Hodgkin lymphoma: a case report from IranNahid Reisi Dehkordi,a Parvin Rajabi,b Azar Naimi,*,c and Mitra Heidarpourd
Occurrence of LCH after Hodgkin lymphoma is seen in less than 0.3% of cases. It can occur before, after or simultaneously with Hodgkin Lymphoma.
![Page 28: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/28.jpg)
Korean J Intern Med. Dec 2012; 27(4): 459–462.
Langerhans Cell Histiocytosis Followed by Hodgkin's LymphomaIK Soo Park,1 In Keun Park,1 Eun Kyoung Kim,1 Shin Kim,1 Sang Ryong Jeon,2 Joo Ryung Huh,3 and Cheol Won Suh 1
This condition should be considered in the differential diagnosis of recurrent lymphoma
![Page 29: Case 4](https://reader031.fdocuments.us/reader031/viewer/2022020208/55c7208cbb61eb9d738b4603/html5/thumbnails/29.jpg)
Thank
you