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case_images: Ultrasound image of involved lymph nodes.
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case_images: Ultrasonography examination revealed pathologic round-shaped, hypoechoic lymph nodes with no clear hilum along neck vessels (Figure 1).
case_images: Fused positron emission tomography-fluorodeoxyglucose (PET-FDG) image before AVD treatment.
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case_images: PET-FDG (fluorodeoxyglucose)-images revealed chemical activity within left extensive cervical lymphadenopathy, which was well documented on coronal reconstruction (Figure 2).
case_images: HE (magnification 400x).
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case_images: A mixed cellular infiltrate with lymphocytes, macrophages, and eosinophils was distributed among lymphoid follicles (Figure 3).
case_images: HE (magnification 100x).
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case_images: Reed-Sternberg cells with large purple nucleoli were observed in this background (Figure 4).
case_images: Immunohistochemical staining CD30 (magnification 400x). The stains included anti-CD20, CD3, CD30, CD15, PAX5, MUM-1, Ki-67.
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case_images: Malignant Hodgkin/Reed-Sternberg (HRS) cells were rather small and mononuclear, with CD30 positivity (Figure 5).
case_images: HE immunohistochemical staining (magnification 400x). The stains included anti-CD20, CD3, CD30, CD15, PAX5, MUM-1, Ki-67.
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case_images: PAX5 immunostaining revealed a weak reaction in the nuclei of HRS cells and a strong reaction in the nuclei of small benign B lymphocytes (Figure 6).
case_images: Interphase BCR/ABL1 FISH analysis showing 2 green (22q11.2) and 2 red (9q34) signals in cells. Record according to ISCN 2016 - nuc ish(ABL1,BCR)x2. Analysis was performed on 3-4 microm formalin-fixed and paraffin-embedded (FFPE) lymph node sections using the commercial BCR/ABL1 DCDF probe from Vysis. The areas analyzed were identified and marked by a pathologist. Slides were then dewaxed using the Paraffin Pretreatment Reagent Kit (Vysis, Abbott) and subjected to overnight hybridization with a molecular probe according to the manufacturer's protocol (Vysis, Abbott).
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case_images: FISH BCR-ABL1 analysis of lymph nodes showed a normal pattern of signals, and translocation t(9;22)(q34;q11) was not present (Figure 7).