case_images: PMC4531629_01
case_images: Numerous flesh-colored nodular skin lesions over the chest wall.
case_images: kjim-18-3-202-13f1.jpg
case_images: PMC4531629_01_kjim-18-3-202-13f1.jpg
case_images: f1-kjim-18-3-202-13
case_images: A physical examination at presentation showed multiple pigmented lesions of the skin, called cafe au lait spots, and rubbery nodular skin lesions on the chest, abdominal wall and both arms (Figure 1).
case_images: Chest CT scan showing well-defined hypodense masses (arrow) in the right axillary region.
case_images: kjim-18-3-202-13f2.jpg
case_images: PMC4531629_01_kjim-18-3-202-13f2.jpg
case_images: f2-kjim-18-3-202-13
case_images: A chest CT scan confirmed the presence of several lymph node enlargements in the right axillary region; the size of the largest enlargement was 3.5x3.0 cm (Figure 2).
case_images: (A) Contrast enhanced CT scan showing well-defined, conglomerated, hypodense masses (arrow) around both para-aortic areas. (B) Hypodense, well-defined masses (arrow) were noted at the left side pelvic cavity, displacing the left distal ureter medially. Arrowhead: left external femoral vein.
case_images: kjim-18-3-202-13f3.jpg
case_images: PMC4531629_01_kjim-18-3-202-13f3.jpg
case_images: f3-kjim-18-3-202-13
case_images: An abdominal CT scan showed isodense homogeneous conglomerated para-aortic lymphadenopathy and a soft tissue density mass in the left pelvic cavity (Figure 3).
case_images: The mass was mainly composed of large cells with prominent nuclei and high mitotic activity (arrow). H&E, x200.
case_images: kjim-18-3-202-13f4.jpg
case_images: PMC4531629_01_kjim-18-3-202-13f4.jpg
case_images: f4-kjim-18-3-202-13
case_images: A microscopic examination showed irregular nests of malignant lymphoma cells with hyperchromatic and round nuclei (Figure 4).