March-2017-CSBRP
Case studies in Lymphomas
Dr.CSBR.Prasad, MD.,
March-2017-CSBRP
Case-1• 52yo, F. complains of painless enlarging lumps in both axilla for the past 3months• She has weakness and dry cough since one month• Chest radiograph reveled 1cm mass with irregular margins in the right lower lung
lobe• CT failed to show any cavitation / calcification in the mass• There is no hilar / mediastinal lymphadenopathy• Local examination: Right axilla – matted lymphnodes meauring 5cm in diameter.
Left axilla – 4 discreet firm lymphnodes. There are two discreet lymphnodes in the left upper cervical region
• There is no organomegaly• CBC was normal• ESR 80mm at the end of 1st hour• FNAC of lung nodule was performed
March-2017-CSBRP
AP view
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Lateral view
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FNAC smear from lung lesion
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FNAC smear from right axillary lesion
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Excised axillary lymph node
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Excised axillary lymphnode
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Excised axillary lymphnode
March-2017-CSBRP
• What are your findings in the x-ray chest• Describe the cytology smears• Describe the gross appearance of lymphjnode• What are the findings in histology of
lymphnode?• What is your diagnosis?
March-2017-CSBRP
• What is the stage?
March-2017-CSBRP
Case-2
• 40yo, F. presented with h/o gastritis since many years
• Recently she started to have persistent pain abdomen
• Upper GI Endoscopy is given in the next image• A gastric biopsy was done
March-2017-CSBRP
Endoscopic view of different regions of stomach
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Low power view of gastric biopsy
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Closer view of gastric biopsy
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Case-2
• Describe the endoscopic findings ?• What is shown in the gastric biopsy?• What further test you want to do?• If it is single lesion what is the usual mode of
treatment?
March-2017-CSBRP
Case-3
• 5yo, African girl with rapidly growing jaw swelling of 2months duration
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Plain x-ray
MRI
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FNAC smear
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Biopsy from jaw lesion
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• Describe the clinical image• What do your think of x-ray findings? Is it
malignant or benign?• Describe the FNAC smear• What are your findings in biopsy?• What further test your do confirm your
diagnosis?
March-2017-CSBRP
Case-4
• 70yo, M. was evaluated for weakness• o/e Patient had generalized non tender
lymphadenopathy• CBC was done
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CBC report
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Peripheral Blood smear
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Lymphnode biopsy
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Bone marrow biopsy
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• What are abnormal findings in the CBC report?
• Describe the peripheral blood smear?• Describe the lymphnode biopsy. What those
arrows pointing to?• What are your findings in BM biopsy?• What is the nature of this lesion?
Case-5 Can this be Hodgkin’s Lymphoma?
CSBRP-March-2017
Case-6 Give your findings and DDs
CSBRP-March-2017
Case-7Nuclear imaging
What is your most probable diagnosis?Based on what findings?
CSBRP-March-2017
March-2017-CSBRP