case_images: PMC4763460_01
case_images: Computed tomography of abdomen showing bilateral large adnexal masses with bilateral hydronephrosis due to compression of ureters
case_images: CJ-13-2-g001.jpg
case_images: PMC4763460_01_CJ-13-2-g001.jpg
case_images: F1
case_images: Computed tomography (CT) scan of abdomen showed bilateral large heterogenously enhancing adnexal masses measuring approximately 10 cm x 7 cm (right) and 9 cm x 6 cm (left) with discrete retroperitoneal lymph nodes (varying in maximum dimension from 1.5 to 2.5 cm) compressing both the ureters resulting in hydronephrosis of both the kidneys [Figure 1].
case_images: (a) Dyscohesive tumor cells, Pap, x200; (b) the tumor cells have large round pleomorphic nuclei and conspicuous nucleoli. Lymphoglandular bodies are also seen in the background, Pap, x400; (c) tumor cells show immunopositivity for CD20 x 200; (d) tumor cells dispersed singly, H and E, x100; (e) the tumor cells are large, pleomorphic and show mitoses, H and E; (f) strong immunopositivity for CD20 is seen in the tumor cells, x200
case_images: CJ-13-2-g002.jpg
case_images: PMC4763460_01_CJ-13-2-g002.jpg
case_images: F2
case_images: Aspiration cytology smears from bilateral ovarian masses were highly cellular and showed predominantly dispersed monomorphic population of lymphoid cells [Figure 2].
case_images: PMC4763460_02
case_images: (a) Predominantly dispersed tumor cells; MGG, x100; (b) high nucleocytoplasmic ratio and moderate pleomorphism; MGG x 200; (c) minimal vacoulated cytoplasm, opened up nuclear chromatin and small nucleoli at places; MGG x 400; (d) tumor cells arranged in solid sheet and focally in cords; H and E, x100; (e) minimal cytoplasm, pleomorphic nuclei and frequent apoptoses; H and E, x200; (f) small nucleoli. Macrophages with engulfed debris are also seen; H and E, x400; (g) tumor cells are immunopositive for CD20 (h) BCL6; (i) MIB1 labeling index of 98% x200
case_images: CJ-13-2-g003.jpg
case_images: PMC4763460_02_CJ-13-2-g003.jpg
case_images: F3
case_images: Cytology smears showed a predominantly dispersed population of large cells with scant cytoplasm and conspicuous nucleoli [Figure 3].