case_images: PMC10546969_01
case_images: Video-assisted thoracic surgery acquired samples of left lung lesion, haematoxylin and eosin staining: 50x magnification (A), 100x magnification (B), 200x magnification (C), 400x magnification (D) (red arrow indicates the suspected cell with [Hodgkin's and Reed-Sternberg-like] features)
case_images: WO-27-51354-g001.jpg
case_images: PMC10546969_01_WO-27-51354-g001.jpg
case_images: F1
case_images: Histopathological analysis showed lung tissue with disrupted histoarchitecture, fibrosis, and lymphoid infiltration forming nodules, without features of phlegmonous inflammation or granulomatous vasculitis, but with the presence of dispersed larger cells resembling Hodgkin's and Reed- Sternberg-like cells (HR-S) (Fig. 1).
case_images: Immunophenotyping of the Hodgkin's and Reed-Sternberg-like (HR-S) cells. Immunohistochemical staining of CD30 showing positivity in HR-S cell (50x and 100x magnification, respectively). Hodgkin's and Reed-Sternberg-like cell indicated by a red arrow (A, B), immunohistochemical staining of B cell lineage specific activator protein (PAX5-BSAP) showing weak positivity (C), immunohistochemical staining of octamer binding protein 2 (OCT-2) showing negativity in HR-S cells (D)
case_images: WO-27-51354-g002.jpg
case_images: PMC10546969_01_WO-27-51354-g002.jpg
case_images: F2
case_images: A complex immunophenotyping was performed to differentiate PPHL from other non-Hodgkin B-cell lymphomas, particularly lymphomatoid granulomatosis (Fig. 2).
case_images: Positron emission tomography imaging of the chest (August 2019). In segment 1/2 and in segment 3 and 4, metabolically active tumour (84 x 52 x 64 mm SUVmax = 19.9) with visible small satellite nodules up to 10 mm (SUVmax up to 4.9), enlarged, metabolically active lymph nodes of both lung hilum (20 x 16 mm SUVmax = 10.8 - on the left side, and 16 x 12 mm SUVmax up to 5.8 - on the right side), enlarged, metabolically active subacute lymph node size (25 x 20 mm, SUVmax = 11.8)
case_images: WO-27-51354-g003.jpg
case_images: PMC10546969_01_WO-27-51354-g003.jpg
case_images: F3
case_images: Next, a bone marrow biopsy and positron emission tomography (PET) scan were performed (Fig. 3).