case_images: PMC7381955_01
case_images: Computed tomography of the chest showing the rapidly expanding mediastinal lymphadenopathy. The trachea was compressed with the narrow diameter of <1 cm. (a) Pretreatment. (b) Day 14 following commencement of treatment.
case_images: CRIHEM2020-8363427.001.jpg
case_images: PMC7381955_01_CRIHEM2020-8363427.001.jpg
case_images: fig1
case_images: An urgent computed tomography scan demonstrated cervical and mediastinal lymphadenopathy resulting in tracheal compression (see Figure 1).
case_images: Sheets of large lymphocytes with centroblastic morphology ((a) haematoxylin and eosin stain), with positive immunohistochemistry for high Ki-67 index of 70%, CD20, and MUM1 (b)-(d), respectively.
case_images: CRIHEM2020-8363427.002.jpg
case_images: PMC7381955_01_CRIHEM2020-8363427.002.jpg
case_images: fig2
case_images: Based on paraffin section immunohistochemistry, the neoplastic cells were positive for CD20, CD5 (weak), CD23, CD43, BCL2 (>70%), and MUM1 and were lambda light-chain restricted; the Ki-67 proliferation index was approximately 70% (See Figure 2).