case_images: PMC5122011_01
case_images: Marrow aspirate smear showing examples of hemophagocytosis, May Grunwald Giemsa stain, x 1000
case_images: 12878_2016_65_Fig1_HTML.jpg
case_images: PMC5122011_01_12878_2016_65_Fig1_HTML.jpg
case_images: Fig1
case_images: Hemophagocytic lymphohistiocytosis was strongly suspected according to Henter criteria and a bone marrow aspiration was performed showing a rich marrow with hemophagocytosis (Fig. 1) without lymphomatous infiltration.
case_images: Lymphadenopathy biopsy showing diffuse lymphohystiocytic infiltration the normal architecture with scattered large atypical cells (Arrows), H&E stain, x 400
case_images: 12878_2016_65_Fig2_HTML.jpg
case_images: PMC5122011_01_12878_2016_65_Fig2_HTML.jpg
case_images: Fig2
case_images: These scattered large neoplastic cells are present on a background rich in histiocytes and small lymphocytes (Fig. 2).
case_images: CD20 immunostain highlights large neoplastic B cells, x 400
case_images: 12878_2016_65_Fig3_HTML.jpg
case_images: PMC5122011_01_12878_2016_65_Fig3_HTML.jpg
case_images: Fig3
case_images: CD20 in the large neoplastic cells (Fig. 3) and CD3 in the small T cells (Fig. 4). CD30, CD15 and EBV stains were negative.   
case_images: CT scan abdomen showing a 20 cm large spleen with multiple hypodensities (infarcts)
case_images: 12878_2016_65_Fig5_HTML.jpg
case_images: PMC5122011_01_12878_2016_65_Fig5_HTML.jpg
case_images: Fig5
case_images: Computed tomography (CT) scan of the chest, abdomen and pelvis showed enlarged lymph nodes on both sides of diaphragm and a 20 cm large spleen with multiple hypodensities, likely to be related to infarcts (Fig. 5).