case_images: PMC4812356_01
case_images: Positron Emission Tomography, Computed Tomography Scan. Fusion PET/CT demonstrating diffuse right cervical and left axillary lymphadenopathy.
case_images: CRIOT2016-6469073.001.jpg
case_images: PMC4812356_01_CRIOT2016-6469073.001.jpg
case_images: fig1
case_images: Due to the potential association with NLPHL, PET/CT was performed, and increased uptake was noted in the right parotid, bilateral jugulodigastric chains, right supraclavicular region, right axilla, peripancreatic region, and bilateral inguinal regions (Figure 1).
case_images: PTGC microscopic examination. (a) PTGC, markedly enlarged lymphoid follicle infiltrated by small mature mantle zone lymphocytes with gradual replacement of germinal center (H&E, 4x). (b) Background of florid follicular lymphoid hyperplasia (H&E, 2x). (c) PTGC, germinal center replaced by small mature mantle zone lymphocytes (H&E, 20x). (d) Reactive germinal center with numerous tingle body macrophages (H&E, 20x).
case_images: CRIOT2016-6469073.002.jpg
case_images: PMC4812356_01_CRIOT2016-6469073.002.jpg
case_images: fig2
case_images: Additional excisional biopsy of a particularly high FDG uptake supraclavicular lymph node revealed PTGC without any evidence of malignancy (Figure 2).
case_images: Papillary thyroid cancer microscopic examination. (a) Papillary thyroid carcinoma. Circumscribed nodule with papillary and follicular architecture and background fibrous bands (H&E, 2x). (b) Nuclear crowding, oval to elongated nuclei with fine open chromatin, nuclear membrane irregularity, and nuclear grooves (H&E, 40x). (c) Lymph node showing metastatic papillary thyroid cancer (H&E, 4x). (d) Metastatic papillary thyroid cancer nuclear features (nuclear crowding, fine open chromatin pattern, nuclear grooves, and nuclear membrane irregularity) (H&E, 40x).
case_images: CRIOT2016-6469073.003.jpg
case_images: PMC4812356_01_CRIOT2016-6469073.003.jpg
case_images: fig3
case_images: Pathology confirmed papillary thyroid carcinoma (Figure 3), and two of four lymph nodes demonstrated metastatic disease without extranodal invasion.