case_images: PMC11835113_01
case_images: Doppler and ultrasound imaging of axillary lymph nodes. (A) Doppler blood flow image of the lymph nodes in the left axilla. (B) Doppler blood flow image of the lymph nodes in the right axilla. (C) Ultrasound image of the lymph nodes in the left axilla.
case_images: medi-104-e41559-g001.jpg
case_images: PMC11835113_01_medi-104-e41559-g001.jpg
case_images: F1
case_images: Ultrasound examination showed multiple enlarged lymph nodes in both axillae, some measuring up to 45 mm x 15 mm on the left (Fig. 1A) and 30 mm x 12 mm on the right (Fig. 1B). The ultrasound images confirmed bilateral axillary lymphadenopathy (Fig. 1C) and suggested the possibility of malignancy.
case_images: Gross and histopathological images of enlarged axillary lymph nodes. (A) Gross specimen of the enlarged lymph node in the left axilla. (B-D) Histopathological images under the microscope showing multiple enlarged lymph nodes from the left axilla, observed under 8 x magnification with a scale bar of 500 mum.
case_images: medi-104-e41559-g002.jpg
case_images: PMC11835113_01_medi-104-e41559-g002.jpg
case_images: F2
case_images: Intraoperatively, a 4 cm x 3 cm x 1 cm gray-red, soft, encapsulated lymph node was completely excised (Fig. 2A). Histopathological examination (Figs. 2B-D, and 3A) demonstrated numerous enlarged lymphoid follicles with concentric (onion-skin) layering of lymphocytes and prominent vascular proliferation, consistent with hyaline vascular type CD.
case_images: Histopathological and immunohistochemical analysis of the excised lymph node. (A) hematoxylin and eosin staining for pathological analysis. (B-L) Immunohistochemical staining for various markers: (B) CD21, (C) CD3, (D) CD20, (E) CD5, (F) CD43, (G) CyclinD1, (H) CD38, (I) Bcl-2, (J) kappa, (K) lambda, and (L) Ki67. All images were observed under 200 x magnification with a scale bar of 20 mum.
case_images: medi-104-e41559-g003.jpg
case_images: PMC11835113_01_medi-104-e41559-g003.jpg
case_images: F3
case_images: Histopathological examination (Figs. 2B-D, and 3A) demonstrated numerous enlarged lymphoid follicles with concentric (onion-skin) layering of lymphocytes and prominent vascular proliferation, consistent with hyaline vascular type CD. Immunohistochemistry showed CD21, CD3, CD20, CD5, CD43, CyclinD1(-), CD38, Bcl-2, Kappa (scattered+), Lambda (scattered+), Ki67 (about 10%), confirming the diagnosis (Fig. 3B-L).