case_images: PMC6305950_01
case_images: Computed tomography scan of the head and neck. (A) A 7.3 x 3.1 x 6.6-cm mass in the neck, located adjacent to the esophagus. (B) The lesion appeared to be closely apposed with the vertebral body without apparent compression.
case_images: 10.1177_2324709618820887-fig1.jpg
case_images: PMC6305950_01_10.1177_2324709618820887-fig1.jpg
case_images: fig1-2324709618820887
case_images: Computed tomography (CT) scan of the head and neck showed a 7.3 x 3.1 x 6.6-cm mass in the neck, which was inseparable from the cervical esophagus (Figure 1A). It was located adjacent to the vertebral body without apparent bone compression (Figure 1B).
case_images: Photomicrograph of the biopsy specimen of the neck mass demonstrating large malignant lymphocytes with an amphophilic cytoplasm. The nuclei are round to ovoid with vesicular chromatin and variable number of nucleoli (hematoxylin-eosin; 400x).
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case_images: PMC6305950_01_10.1177_2324709618820887-fig2.jpg
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case_images: Histopathologic analysis of the biopsy specimen showed relatively large malignant lymphocytes with a moderately abundant cytoplasm and round-to-ovoid nuclei having prominent nucleoli and occasional mitoses (Figure 2).
case_images: Immunohistochemical analysis of the biopsy of the neck mass. (A) Positive staining of malignant lymphocytes for the CD20 antibody (CD20; 100x). (B) Positive staining for the CD10 antibody (CD10; 400x). (C) Malignant lymphocytes were positive for the BCL6 antibody (BCL6; 400x). (D) The Ki-67 proliferative index was very high (up to 80%).
case_images: 10.1177_2324709618820887-fig3.jpg
case_images: PMC6305950_01_10.1177_2324709618820887-fig3.jpg
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case_images: Immunohistochemical examination yielded positive results for CD20 and CD10 antibodies, whereas staining was diffusely positive for BCL6 antibody (Figure 3A-C). The lesion was classified as high grade due to a very high Ki-67 proliferative index (Figure 3D).