case_images: PMC10500239_01
case_images: Swollen, erythematous, warm skin, and a firm palpable mass at anterolateral side of the right thigh with open central necrosis and multiple fistulas.
case_images: NCI-10-527-g001.jpg
case_images: PMC10500239_01_NCI-10-527-g001.jpg
case_images: F1
case_images: There was an 8 x 6 cm in diameter open central necrotic and infected area, and at the lateral side of it, there were multiple fistulas with purulent discharge (Fig. 1).
case_images: (A) Maggot therapy, (B) Maggot therapy.
case_images: NCI-10-527-g002.jpg
case_images: PMC10500239_01_NCI-10-527-g002.jpg
case_images: F2
case_images: Because of the slow progress in wound healing, the maggot therapy was considered, for this purpose, Lucilia sericata larvae were used (Fig. 2A, B).
case_images: (A) Diffuse infiltration of large atypical mononuclear cells (H&E x 200), (B) Atypical mononuclear cells with CD20 expression (CD20 x 200), (C) Atypical mononuclear cells with CD30 expression (CD30 x 200), (D) Epstein-Barr virus-encoded small RNA (EBER) positivity demonstrated by in situ hybridization technique in atypical mononuclear cells (EBER x 100).
case_images: NCI-10-527-g003.jpg
case_images: PMC10500239_01_NCI-10-527-g003.jpg
case_images: F3
case_images: In the meantime, the pathologic re-examination of the paraffin blocks and slides was surprisingly revealed an Epstein-Barr virus (EBV)-positive DLBCL (Fig. 3A-D).
case_images: Vacuum-assisted closure applied on the wound.
case_images: NCI-10-527-g004.jpg
case_images: PMC10500239_01_NCI-10-527-g004.jpg
case_images: F4
case_images: To accelerate the wound treatment, vacuum-assisted closure (VAC) was applied (Fig. 4).
case_images: Final condition of the right thigh after successfully wound management.
case_images: NCI-10-527-g005.jpg
case_images: PMC10500239_01_NCI-10-527-g005.jpg
case_images: F5
case_images: The patient had noticeable weight gain, was able to move on his feet, and was discharged after a hospital stay of 2 months (Fig. 5).