67 yrs female with clinically indolent disease, fatigue, lymphadenopathy.
Axillary lymph node biopsy and threpine biopsy was performed. Unfortunatelly the patient was deceased soon after biopsy.
FULL HISTORY: 2007 acute pneumonia and uncertain hepatosplenomegaly. 2008 deep anemia and transfusions. Massive visceral lymphadenopathy and hepatosplenomegaly, subfebrile fever. Due to positive blood culture (Gram(-)) the patient was hospitalized (sepsis). Infiltration in the left lung, pleuritis hypoechoic nodules up to 3cm in the spleen were found. Therapy: antibiotics, duretics and transfusions. Due to dyspnea and progressing bacteriemic shock the patient was deceased. The autopsy was declined. EBV evaluation was not done.
HISTO: 1. NODE: Focal cHL picture with a reach of tumor cells areas DLBCL like.
IH: CD20+; CD30+; CD15-; EBV LMP1+; LCA+; CylinD1-; EMA-; p53+; Mum1+; Bcl6- (single +, low quality); CD10-. BM: 2 deformed nidus of fibrosis with atypical cells (HL like picture):CD20+; CD30+/-; CD15- (LOW QUALITY).
DIFFERENTIAL: CLASSIC EBV+ HOGDKIN'S LYMPHOMA (VARIANT?) vs EBV DRIVEN B LYMPHOPROLIFERATION/DLBCL.
Age related EBV associated LPD
