case_images: PMC6915144_01
case_images: Mammography showing enlarged lymph node in the right axilla. No specific abnormalities were detected in the breast.
case_images: CRIHEM2019-9256807.001.jpg
case_images: PMC6915144_01_CRIHEM2019-9256807.001.jpg
case_images: fig1
case_images: A mammography, performed when the axillary mass, was first observed, and it did not detect any abnormality in the breast, except of an enlarged lymph node in the axilla (Figure 1).
case_images: CT revealing breast lesion with partially ill defined borders, thickening of the breast skin, and lymphedema (a) and enlarged axillary lymph nodes (b).
case_images: CRIHEM2019-9256807.002.jpg
case_images: PMC6915144_01_CRIHEM2019-9256807.002.jpg
case_images: fig2
case_images: In addition, CT revealed a lesion with ill-defined border in the right breast considered suspicious for primary malignancy, skin thickening, and lymphedema (Figure 2).
case_images: US revealing a small hypoechoic breast lesion with partially ill-defined borders and mild posterior acoustic enhancement.
case_images: CRIHEM2019-9256807.003.jpg
case_images: PMC6915144_01_CRIHEM2019-9256807.003.jpg
case_images: fig3
case_images: It was classified as BIRADS 4 (Figure 3).
case_images: Cytology: (a) breast FNA showing scattered Reed-Sternberg and Hodgkin cells admixed with lymphocytes and eosinophils (Hemacolor stain, 20X); (b) Reed-Sternberg and Hodgkin cell variants (Hemacolor stain, 40X); (c) CD30 immunoreactive Hodgkin cell in cytology smear (ABC, 40X). Histology: (d) lymph node specimen showing Reed-Sternberg and Hodgkin cells in a classic milieu (H & E stain, 25X); (e) CD30 immunoreactive Reed-Sternberg and Hodgkin cells; typical Golgi pattern of chromogen distribution (25X); (f) Reed-Sternberg and Hodgkin cells with Golgi pattern immunopositive for CD15 (25X).
case_images: CRIHEM2019-9256807.004.jpg
case_images: PMC6915144_01_CRIHEM2019-9256807.004.jpg
case_images: fig4
case_images: Small CD4 positive lymphocytes focally formed rosettes around Hodgkin cells (Figure 4).