case_images: PMC6292348_01
case_images: Chest CT scan- Axial view: Normal parenchymal lung tissue without evidence of active chest disease or intrathoracic lymphadenopathy.
case_images: ZJCH_A_1539057_F0001_PB.jpg
case_images: PMC6292348_01_ZJCH_A_1539057_F0001_PB.jpg
case_images: F0001
case_images: Tomography (CT) scan of Chest (Figure 1). CT scan of Abdomen and Pelvis revealed hepatosplenomegaly with large retroperitoneal, retrocrural, and mesenteric lymphadenopathy (Figure 2(a,b)) which had an intense focal uptake on Gallium scan with no abnormal lung uptake (Figure 3). The presence of Monoclonal IgG along with hepatosplenomegaly and retroperitoneal lymphadenopathy, elevated
case_images: (a) Abdomen and pelvis CT scan: The liver is large measuring up to 24 cm (blue arrows). The spleen is large measuring 17.4 cm (red arrows), retrocrural lymphadenopathy (white arrows). (b) Abdomen and pelvis CT scan: Retroperitoneal lymph nodes (white arrows).
case_images: ZJCH_A_1539057_F0002_PB.jpg
case_images: PMC6292348_01_ZJCH_A_1539057_F0002_PB.jpg
case_images: F0002
case_images: Tomography (CT) scan of Chest (Figure 1). CT scan of Abdomen and Pelvis revealed hepatosplenomegaly with large retroperitoneal, retrocrural, and mesenteric lymphadenopathy (Figure 2(a,b)) which had an intense focal uptake on Gallium scan with no abnormal lung uptake (Figure 3). The presence of Monoclonal IgG along with hepatosplenomegaly and retroperitoneal lymphadenopathy, elevated
case_images: Gallium scan: Large region of intense focal uptake midline abdomen compatible with mesenteric (blue arrows) and retroperitoneal lymphadenopathy (white arrows). No abnormal lung uptake is seen.
case_images: ZJCH_A_1539057_F0003_PB.jpg
case_images: PMC6292348_01_ZJCH_A_1539057_F0003_PB.jpg
case_images: F0003
case_images: Tomography (CT) scan of Chest (Figure 1). CT scan of Abdomen and Pelvis revealed hepatosplenomegaly with large retroperitoneal, retrocrural, and mesenteric lymphadenopathy (Figure 2(a,b)) which had an intense focal uptake on Gallium scan with no abnormal lung uptake (Figure 3). The presence of Monoclonal IgG along with hepatosplenomegaly and retroperitoneal lymphadenopathy, elevated
case_images: Lymph node biopsy: (hematoxylin and eosin stain) lymphohistiocytic infiltrate (red arrows).
case_images: ZJCH_A_1539057_F0004_PB.jpg
case_images: PMC6292348_01_ZJCH_A_1539057_F0004_PB.jpg
case_images: F0004
case_images: A subsequent biopsy of the lymph nodes showed fragments of fibrous tissue with lymphohistiocytic infiltrate (Figure 4) and many acid-fast bacilli on special stain (Figure 5).
case_images: Lymph node biopsy: Many acid-fast bacilli (blue arrows).
case_images: ZJCH_A_1539057_F0005_PB.jpg
case_images: PMC6292348_01_ZJCH_A_1539057_F0005_PB.jpg
case_images: F0005
case_images: A subsequent biopsy of the lymph nodes showed fragments of fibrous tissue with lymphohistiocytic infiltrate (Figure 4) and many acid-fast bacilli on special stain (Figure 5).