Case 771 -- A 49 year old female with nausea and vomiting

Contributed by Sarika Jain, MD and Steven H Swerdlow, MD


A 49 year old female presented to the hospital with nausea and vomiting. CT scan of the abdomen demonstrated gastric and duodenal masses and retroperitoneal lymphadenopathy. She underwent retroperitoneal lymph node, gastric body, gastric antrum and duodenal biopsies.


Histologic sections of the duodenum and the gastric body demonstrate dense infiltration of the lamina propria by intermediate to mostly large cells with dispersed chromatin and prominent nucleoli along with a moderate number of mitotic figures (Figures 1 and 2). The histologic sections from the retroperitoneal lymph node demonstrate multiple needle cores of fibroadipose tissue with possible lymph node showing a diffuse proliferation of similar cells with many mitotic figures and a focal starry sky appearance with tingible body macrophages (Figure 3).


Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Figure 14

Figure 15

No phenotypic aberrancy was identified using stains for CD5, CD7, CD2, CD4 and CD8. Infiltrate was negative with immunohistochemical stains for Bcl-6, cyclin D1, myeloperoxidase, lysozyme, CD117, and CD68/PGM-1.

Peripheral blood/ Bone marrow: Negative for Blasts.


Case IndexCME Case StudiesFeedbackHome