case_images: PMC9464022_01
case_images: Left pelvic cyst-solid mass with ultrasound (size 16.3x9.7x7.6 cm). Criss-cross: left pelvic cyst-solid mass.
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case_images: An abdominal ultrasound showed an increased liver parenchyma echo, splenomegaly, a small amount of effusion in the right iliac fossa, and a bilateral pelvic-cyst solid mass (Figure 1).
case_images: CT showed effusion of bilateral thoracic cavities (yellow arrow).
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case_images: Computed tomography scanning showed an effusion of bilateral thoracic cavities (Figure 2).
case_images: MRI showed abnormal signals of bilateral appendages, multiple small nodule shadows in greater omentum, lesser omentum and mesentery, abnormal signal shadows in pelvis, sacrum, thoracic vertebrae and lumbar vertebrae, effusion in abdominal, pelvic cavities. (A) T1WI, (B) T2WI, (C) STIR, (D) T1+ C. White arrow: iliac bone metastasis.
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case_images: Furthermore, magnetic resonance imaging showed abnormal signals of the bilateral appendages, abnormal lymph node shadows of the lesser curvature of the stomach in the abdominal cavity, multiple small nodule shadows in the greater omentum, lesser omentum, and mesentery, abnormal signal shadows in the pelvis, sacrum, thoracic vertebrae, and lumbar vertebrae, and effusion in the abdominal and pelvic cavities (Figure 3).
case_images: The bone marrow showed clustered abnormal cells (A) and haemophagocytes (B) (Wright-Giemsa staining, original magnification x 1000).
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case_images: B cells were slightly higher, natural killer (NK) percentages and counts were noticeably decreased, and the remaining lymphocyte subsets and CD4/CD8 were within the reference ranges (Table 2). Bone marrow cytomorphology revealed clustered abnormal cells and hemophagocytes, mainly RBC and hemosiderin in the cytoplasm (Figure 4).