Microscopic Description -- Right Neck Mass


There were a few residual, benign appearing follicles with germinal centers identified. There were other areas with cyst-like spaces lined by columnar cells with eosinophilic granular cytoplasm (Figures 1, 2 and 3). In addition, there were pale nodular areas surrounded by a diffuse lymphoid infiltrate (Figures 4 and 5). This lymphoid infiltrate consisted of a proliferation of small lymphocytes with round nuclei. The nodules contain more numerous large cells including prolymphocytes and para-immunoblasts (Figure 6). Paraffin section immunohistochemical stains revealed the tumor cells to be CD20 positive diffusely positive with variable positivity (Figure 7), CD5 weak positive staining in tumor cells (Figure 8), and CD43 diffusely positive (Figure 9), and CD23 and cyclin D1 negative (not pictured).


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