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病例2 (会1985-1 女 66岁 )
病史:2007-10发热,口服头孢三代施博后发现颈部双侧、右腋下淋巴结肿大,一直发热。07-10到11月,用药期间过敏三次(病人过敏体质)。11-17做第一次手术,部位颈部、右腋下,几家医院分别诊断为“非霍奇金小细胞淋巴瘤”;可能为FL;EBV感染引起的淋巴结反应性增生;淋巴结反应性增生;非典型淋巴结增生,等几种不同诊断;08-2-10左右,左侧腹股沟淋巴结肿大,直径3x2cm,腹部淋巴结、后腹膜淋巴结肿大。08-4-24第二次手术,左侧腹股沟淋巴结活检,切片为本次活检。
panzenggang 离线
The architecture of the entire lymph node is effaced with prominent vasculature and eosinophilia. Scattered atypical large cells are present with moderate to abundant cytoplasm and prominent nucleoli.
Differential diagnoses:
1. Angioimmunoblastic T-cell lymphoma (most likely)
2. HD, mixed cellular type (not likely)
3. Reactive process (last choose)
Suggested further workup:
IPX: CD3, CD4, CD7, CD10, CD20, CD21, BCL2, BCL6, CD15, CD30
ISH: EBER
TCR and BCR gene rearrangement