case_images: PMC5836236_01
case_images: Lymph node enlargement. a Postauricular. b Left inguinal.
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case_images: PMC5836236_01_cro-0011-0055-g01.jpg
case_images: F1
case_images: Widespread lymph node enlargement was observed in the head and neck region, as well as the presence of bilateral axillary nodes, and inguinal nodes (Fig. 1).
case_images: Bone marrow aspirate showing plasma cells actively producing immunoglobulins "Mott cells" (a) and hemophagocytosis of RBC and neutrophils (b).
case_images: cro-0011-0055-g02.jpg
case_images: PMC5836236_01_cro-0011-0055-g02.jpg
case_images: F2
case_images: The bone marrow aspirate revealed reactive hypercellular bone marrow with Mott cells (active plasma cells) and abnormal histiocytes with a high hemophagocytic activity (Fig. 2).
case_images: Lymph node biopsy showing: large histiocytes with emperipolesis (black arrows) and plasma cells with large inclusions containing immunoglobulins "Russel body" (yellow arrow) (a); immunohistochemical staining of lymph node biopsy, positive for S100 (b); immunohistochemical staining of lymph node biopsy, positive for CD68 (c); immunohistochemical staining of lymph node biopsy, negative for CD1a (d); and immunohistochemical staining of lymph node biopsy, negative for CD21 (e).
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case_images: PMC5836236_01_cro-0011-0055-g03.jpg
case_images: F3
case_images: A lymph node biopsy from the anterior cervical group (Fig. 3) showed that the sinusoids were extended and filled with S100 and CD68-positive but CD1a-negative histiocytes with abundant cytoplasmic fat globules and exhibited emperipolesis (viable lymphocytes inside the cytoplasm of histiocytes).