case_images: PMC5317071_01
case_images: Maximum Intensity Projection (MIP) image of FDG PET/CT scan showing intense uptake in axial as well as appendicular skeleton, which appears focal and patchy at some sites B, Fused 18 F-FDG PET/CT transaxial image showing intense tracer uptake in multiple thyroid nodules in an enlarged thyroid gland.
case_images: IJNM-32-46-g001.jpg
case_images: PMC5317071_01_IJNM-32-46-g001.jpg
case_images: F1
case_images: Also noted were FDG avid lesions in skull, cervical, dorso-lumbar vertebrae, sternum, ribs, bilateral pelvic bones, humerus, and femur. [Figure 1A and B].
case_images: Cellular thyroid aspirate comprising intermediate to large sized atypical lymphoid cells with scant cytoplasm and fine chromatin (Giemsa stain A, 20x B, 40x)
case_images: IJNM-32-46-g002.jpg
case_images: PMC5317071_01_IJNM-32-46-g002.jpg
case_images: F2
case_images: A cytological impression of high grade non Hodgkin lymphoma (NHL) involving the thyroid gland was offered. [Figure 2A and B].
case_images: Bone marrow biopsy showing A, hypercellular marrow with near total replacement of hematopoietic cells by leukemic cells (H and E 200x) B, CD 20 C, Tdtimmunopositivity (200x) Flow cytometry showing leukemic cells positive for D, CD 34 E, CD79a F, cMPO
case_images: IJNM-32-46-g003.jpg
case_images: PMC5317071_01_IJNM-32-46-g003.jpg
case_images: F3
case_images: Thyroid Biopsy showing A, infiltration of thyroid parenchyma by leukemic cells (H and E, 200x) B, CD 34 C, CD 20 D, CD 43 immunopositivity (200x)
case_images: IJNM-32-46-g004.jpg
case_images: PMC5317071_01_IJNM-32-46-g004.jpg
case_images: F4