case_images: PMC10740371_01
case_images: (A-D) Histopathology of the supraclavicular lymph node at initial presentation in 2015 (panel A-D) and right cervical lymph node at relapse in 2019 (panel E-H). (A) Hematoxylin-eosin stain shows scattered large Hodgkin Reed-Sternberg (HRS) cells in a reactive background of small lymphocytes, histiocytes and sporadic eosinophilic granulocytes; (B) EBER (Epstein-Barr encoding region) shows sparse positive small and slightly enlarged lymphocytes, but HRS-cells are negative; (C) CD30 is uniformly positive in HRS-cells as well as in a range of immunoblasts and small lymphocytes; (D) CD20 is negative in HRS-cells. (E) Hematoxylin-eosin stain shows a larger morphological spectrum of scattered large HRS cells and immunoblasts; (F) EBER shows a high proportion of positive cells with a typical range of HRS-cells to small lymphocytes; (G): CD30 is uniformly positive in HRS-cells as well as in a range of immunoblasts and small lymphocytes; (H) CD79a positive in these cells.
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case_images: F1
case_images: FDG-positive lymphadenopathy both above and below the diaphragm, as well as bronchiectasis. A diagnosis of CHL was confirmed through a supraclavicular lymph node biopsy sample (Figures 1A-D). Four years later, he presented with recurrent CHL, involving cervical, supraclavicular and mediastinal lymph nodes. The diagnosis was confirmed through a cervical lymph node biopsy (Figures 1E-H).
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case_images: PMC10740371_04
case_images: Flowcytometric analysis of cell surface NKG2D expression on PBMC, gated on CD3+CD4+ T cells, CD3+CD8+ T cells, CD3-CD16/56+ NK cells, of a healthy control and the patient. Histograms normalized for cell number per subset. MFI: mean fluorescence intensity for NKG2D cell surface expression on NK-cells (yellow), CD8-positive T-cells (blue) and CD4-positive T-cells (red).
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case_images: F2
case_images: T-cells serves as the gold standard for confirming this diagnosis. The patient exhibited markedly decreased NKG2D expression on his CD8-positive T-cells [mean fluorescence index (MFI) 25%] and NK-cells (MFI 8%) compared to a healthy control (MFIs 87 and 84%, respectively) (Figure 2).
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