A 73-year-old female patient with no relevant morbid history.
The disease began 6 years prior to hospitalization with progressive right axillary adenomegaly accompanied by diaphoresis, without therapeutic management.
Subsequently, three months prior to admission, the patient was referred for cancer of the right axillary lymph node enlargement of approximately 7 cm. She came to the hospital with an oncologist and an incisional biopsy of the lymph node with a diagnostic suspicion of lymphoma.
Upon admission, the patient was in good general condition and physical examination revealed right cervical adenomegaly of 4 cm, of major axis.
Blood biometry reported leukocytes 8.4 thousand/mm3, hemoglobin of 1 g/dl and platelets 295 thousand/mm3.
PET-CT showed an abnormal increase in radiotracer activity in the right cervical (SUVmax 29.6) and left cervical (SUVmax 7.5), retropectoral (SUmax 23SUV2), mediastinal (SUVmax 237).
In the review of the new paraffin block sections of the axillary lymph node, loss of normal architecture was observed due to expansion of the interfollicular and medullary space by mature plasma cells.
Immunohistochemistry was positive for CD 138, kappa and lambda in plasma cells.
Focally, solid areas with ill-defined borders were identified, consisting of large nuclei cells, prominent nucleolus and large basophilic cytoplasm, which gave them a plasmablastic aspect.
In these areas the cytological atypia was marked with occasional mitotic figures.
Immunohistochemical reactions were performed using antibodies against: CD 3 (Policlonal; 1:200 Dako), CD 20 (L26; 1:400 Dako), CD 38 (AT13/5; 1:2515 DBS),
Located cells expressed CD 38, MUM-1, light chainsmbda and LANA-1 HVSK/VH8.
EBER was negative, which confirmed the diagnosis of LCGBEC.
The HIV ELISA test and the hepatitis viral profile were negative.
In addition, bone marrow biopsy and aspiration were performed, both reported without aspiration.
She was stage III (Annn Arbor) and started treatment with R-CHOP (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin hydrochloride 100/5 mg/m2).
Currently, the patient is in remission, with no evidence of disease, after 18 months of follow-up.
