case_images: PMC9124141_01
case_images: Chest computed tomography scans. (a) The initial scan shows a solid nodular lesion with irregular margins and adjacent to the visceral pleura in the right lower part of the upper lobe. (b) Five years later, the CT scan revealed only a small scar in the former lesion.
case_images: CRIM2022-2242418.001.jpg
case_images: PMC9124141_01_CRIM2022-2242418.001.jpg
case_images: fig1
case_images: This finding was confirmed by computed tomography (CT) showing a solid nodular lesion with irregular margins adjacent to the visceral pleura with a diameter of 1.2 inches in the upper right lobe (Figure 1).
case_images: Histopathological appearances of the tumour. (a, b) Lymphoproliferative lesion was composed of dense infiltrates of mature lymphocytes and sporadic plasma cells along with lymphoid follicles with germinal centers. (a) Hematoxylin-eosin (H&E), x10. (b) H&E, x40. (c, d):Immunohistochemical (IHC) staining for immunoglobulin (Ig) k (c) and Ig lambda. (d) Light chains revealed polyclonal reactivity (x40). (e) IHC staining using CD20 antibodies showed high densities of B cells in reactive follicles. (f) Ki-67 IHC staining revealed high proliferative activity in the germinal center with no evidence of malignancy.
case_images: CRIM2022-2242418.002.jpg
case_images: PMC9124141_01_CRIM2022-2242418.002.jpg
case_images: fig2
case_images: Under suspicion of malignancy, a CT-navigated core biopsy (diameter: 0.75 inches) was obtained showing well-defined lymphoid tissue masses with numerous reactive germinal centers, interfollicular lymphocytes, and plasma cells (Figure 2). CD20 and CD10 identified B cells, which were negative for Bcl-2 (Figure 2(e)). CD3-positive T cells showed reactive patterns in the interfollicular zone. Ki-67 staining confirmed a high proliferative activity in reactive follicles with no evidence of malignancy (Figure 2(f)).