case_images: PMC10625811_01
case_images: Histological and immunohistochemical confirmed the diagnosis of diffuse large B-lymphoma with a high proliferation index (Ki-67: 60%) and CD20-positive, CD3-negative, BCL2-negative.
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case_images: PMC10625811_01_cro-2023-0016-0001-533300_F01.jpg
case_images: F1
case_images: The combined histological and immunohistochemical analyses led to the diagnosis of large diffuse B-cell lymphoma with a high proliferation index (Ki-67:60%) and CD20-positive, CD3-negative, and BCL2-negative cells (Fig. 1).
case_images: Abdominal computed tomography with contrast revealed a circumscribed round mass, lobulated edges, and heterogeneous enhancement within the mass in the left adrenal gland (10 x 8 cm).
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case_images: PMC10625811_01_cro-2023-0016-0001-533300_F02.jpg
case_images: F2
case_images: However, abdominal CT with contrast revealed a circumscribed round mass, lobulated edges, and heterogeneous enhancement within the mass in the left adrenal gland (10 x 8 cm) (Fig. 2).
case_images: Immunohistochemical stain results were positive for CD56 in epithelioid cells, chromogranin, synaptophysin.
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case_images: PMC10625811_01_cro-2023-0016-0001-533300_F03.jpg
case_images: F3
case_images: Instead, an excisional biopsy showed a lobulated mass composed of well-defined nests of cuboidal to polygonal cells (Zellballen) surrounded by sustentacular spindle cells, and separated by highly vascularized fibrous septae, with many dilated blood vessels; the individual cells are monomorphic, have a moderately abundant granular basophilic cytoplasm, and focal nuclear pleomorphism (Fig. 3, 4).
case_images: CD56+ Immunohistochemical stain results: epithelioid cells, Chromogranin, and Synaptophysin.
case_images: cro-2023-0016-0001-533300_F04.jpg
case_images: PMC10625811_01_cro-2023-0016-0001-533300_F04.jpg
case_images: F4
case_images: Instead, an excisional biopsy showed a lobulated mass composed of well-defined nests of cuboidal to polygonal cells (Zellballen) surrounded by sustentacular spindle cells, and separated by highly vascularized fibrous septae, with many dilated blood vessels; the individual cells are monomorphic, have a moderately abundant granular basophilic cytoplasm, and focal nuclear pleomorphism (Fig. 3, 4).