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case_images: Comparative pathological findings of ALK-negative ALCL and subsequent PTCL-NOS.. ALK-negative ALCL (a-d) and PTCL-NOS (e-h) samples were analyzed by H&E staining and immunohistochemistry. H&E staining (400x magnification) of ALK-negative ALCL (a) demonstrated clusters of large, round atypical cells, whereas PTCL-NOS (e) showed the infiltrative proliferation of slightly large atypical cells with round to elongated morphology. Immunohistochemical analysis (200x magnification) of ALK-negative ALCL revealed CD4 positivity (b), CD8 negativity (c), and CD30 positivity (d). In contrast, PTCL-NOS cells exhibited CD4 negativity (f), CD8 positivity (g), and CD30 positivity (h). This immunophenotypic shift, coupled with morphological differences, highlights the distinct characteristics of the two T-cell lymphomas occurring in the same patient.
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case_images: TIA-1-, Granzyme B-, Perforin-, Epstein-Barr virus-encoded small ribonucleic acid (EBER)- (Fig. 1). The patient was subsequently admitted to our hospital for further treatment. A pathological examination of these lesions led to a diagnosis of PTCL-NOS (CD3+, CD4-, CD5+, CD8+, CD30+, CD56-, TIA-1-, Perforin-, Granzyme B+, EBER-) (Fig. 1).
case_images: Clinical course following the initiation of treatment.. Six cycles of BV-CHP therapy led to the regression of the left inguinal mass. Observations were performed without further intervention. However, at one month post-treatment, skin lesions emerged on the lower back. FDG-PET imaging revealed cutaneous lesions and hepatic involvement. Monotherapy with BV was initiated. The skin lesions regressed after the first cycle. A repeat FDG-PET scan after 8 cycles demonstrated resolution of the hepatic lesions, indicating CMR. Following the 15th cycle, the patient developed numbness in the fingers, which progressively worsened, leading to the discontinuation of treatment after 20 cycles. No evidence of disease recurrence has been observed since the completion of therapy.
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case_images: The patient underwent six cycles of BV-CHP therapy (Fig. 2). FDG-PET confirmed a complete metabolic response (CMR). Following the 15th cycle, the patient developed numbness in his fingers, which progressively worsened, leading to treatment discontinuation after 20 cycles (Fig. 2).