case_images: PMC5286497_01
case_images: (a) Both components of the histologic picture are seen in this section. Small-to-medium-sized lymphoid cells with clear cytoplasm and eosinophils are segregated by intervening whorls of spindly follicular dendritic cells (H&E x320). (b) Numerous PD1+ cells are found in the cellular area of the lesion consistent with AITL (Immunohistochemistry with DAB x320). (c) Several whorls of follicular dendritic cells are prominent in this section (H&E x320). (d) The spindle follicular dendritic cells show very strong CD21 immunostaining. Note the negative staining related to the high endothelial venules (Immunohistochemistry with DAB x320).
case_images: CRIHEM2017-9601094.001.jpg
case_images: PMC5286497_01_CRIHEM2017-9601094.001.jpg
case_images: fig1
case_images: On low power microscopy, the lymph node structure was effaced and showed two distinct types of histological features (Figure 1(a)). The first consisted of highly cellular areas, composed of small-to-medium-sized cells, often with a clear cytoplasm; these were predominantly T-cells: CD3+++; CD2+++; CD4+++; CD8++; CD5+++; CD7+/(-); PD1++ (Figure 1(b)), in a polymorphous cellular background, including eosinophils and isolated large CD20+ cells. The other aspect of the histology was composed of spindle cells with small uniform nuclei, arranged in whorls formations (Figure 1(c)). These cells were CD21+++ (Figure 1(d)); CD23+++; fascin ++; HLA-DR++.