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Case studies in Lymphomas Dr.CSBR.Prasad, MD., March-2017-CSBRP

Case stuies in Lymphomas

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Page 1: Case stuies in Lymphomas

March-2017-CSBRP

Case studies in Lymphomas

Dr.CSBR.Prasad, MD.,

Page 2: Case stuies in Lymphomas

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

Page 3: Case stuies in Lymphomas

March-2017-CSBRP

AP view

Page 4: Case stuies in Lymphomas

March-2017-CSBRP

Lateral view

Page 5: Case stuies in Lymphomas

March-2017-CSBRP

FNAC smear from lung lesion

Page 6: Case stuies in Lymphomas

March-2017-CSBRP

FNAC smear from right axillary lesion

Page 7: Case stuies in Lymphomas

March-2017-CSBRP

Excised axillary lymph node

Page 8: Case stuies in Lymphomas

March-2017-CSBRP

Excised axillary lymphnode

Page 9: Case stuies in Lymphomas

March-2017-CSBRP

Excised axillary lymphnode

Page 10: Case stuies in Lymphomas

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?

Page 11: Case stuies in Lymphomas

March-2017-CSBRP

• What is the stage?

Page 12: Case stuies in Lymphomas

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

Page 13: Case stuies in Lymphomas

March-2017-CSBRP

Endoscopic view of different regions of stomach

Page 14: Case stuies in Lymphomas

March-2017-CSBRP

Low power view of gastric biopsy

Page 15: Case stuies in Lymphomas

March-2017-CSBRP

Closer view of gastric biopsy

Page 16: Case stuies in Lymphomas

March-2017-CSBRP

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?

Page 17: Case stuies in Lymphomas

March-2017-CSBRP

Case-3

• 5yo, African girl with rapidly growing jaw swelling of 2months duration

Page 18: Case stuies in Lymphomas

March-2017-CSBRP

Plain x-ray

MRI

Page 19: Case stuies in Lymphomas

March-2017-CSBRP

FNAC smear

Page 20: Case stuies in Lymphomas

March-2017-CSBRP

Biopsy from jaw lesion

Page 21: Case stuies in Lymphomas

March-2017-CSBRP

• 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?

Page 22: Case stuies in Lymphomas

March-2017-CSBRP

Case-4

• 70yo, M. was evaluated for weakness• o/e Patient had generalized non tender

lymphadenopathy• CBC was done

Page 23: Case stuies in Lymphomas

March-2017-CSBRP

CBC report

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March-2017-CSBRP

Peripheral Blood smear

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March-2017-CSBRP

Lymphnode biopsy

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March-2017-CSBRP

Bone marrow biopsy

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March-2017-CSBRP

• 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?

Page 28: Case stuies in Lymphomas

Case-5 Can this be Hodgkin’s Lymphoma?

CSBRP-March-2017

Page 29: Case stuies in Lymphomas

Case-6 Give your findings and DDs

CSBRP-March-2017

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Case-7Nuclear imaging

What is your most probable diagnosis?Based on what findings?

CSBRP-March-2017

Page 31: Case stuies in Lymphomas

March-2017-CSBRP