case_images: PMC5470561_01
case_images: - Photomicrography of the lymph node. A - Presence of large, atypical, sometimes multinucleated neoplastic cells (HE, 100X); B - CD30 positive, note the lymph node sinusoidal pattern infiltration (IH, 40X); C - ALK protein positivity (IH, 10X); D - High proliferation rate showed by Ki67 (IH, 10X).
case_images: autopsy-04-01021-g01.jpg
case_images: PMC5470561_01_autopsy-04-01021-g01.jpg
case_images: g01
case_images: The proliferation rate, evaluated by Ki67, was positive in 99% of the neoplastic cell population (Figure 1).
case_images: PMC5470561_02
case_images: - Photomicrography of the bone marrow. A - (HE, 10X); and B - (HE, 100X) showing infiltration by large, atypical, neoplastic cells, with some multinucleated cells in a horseshoe pattern ("hallmark cells"); C - Immunohistochemistry positivity for CD-30 (100X); D - Immunohistochemistry positivity for ALK protein (100X).
case_images: autopsy-04-01021-g02.jpg
case_images: PMC5470561_02_autopsy-04-01021-g02.jpg
case_images: g02
case_images: The diagnosis was confirmed by the immunohistochemical report, which showed a profile consistent with ALK+ ALCL: (positive for CD30, ALK, and EMA, and negative for CD20, CD3, CD15, CD43, CD34, CD31, and myeloperoxidase) (Figure 2).
case_images: - Photomicrography of the lymph node. A - Effacement of the original architecture due to sinusoidal infiltration by large atypical multinucleated cells (HE, 100X); B - Immunohistochemistry positivity for CD30 (HE, 400X).
case_images: autopsy-04-01021-g03.jpg
case_images: PMC5470561_02_autopsy-04-01021-g03.jpg
case_images: g03
case_images: - A - Photomicrography of the liver showing microscopic and multifocal infiltration of the portal tract by large atypical multinucleated cells (HE, 400X); B - Photomicrography of the lung showing focal infiltration of large atypical multinucleated cells in the parenchyma and perivascular. Note hemorrhagic foci and organizing pneumonia (HE, 100X).
case_images: autopsy-04-01021-g04.jpg
case_images: PMC5470561_02_autopsy-04-01021-g04.jpg
case_images: g04
case_images: The lungs, liver, and spleen also showed lymphomatous infiltration (Figure 4).