A case of angioimmunoblastic T-cell lymphoma presenting with migration of lung shadows

Figures

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  Fig. 1. Chest X-rays of the patient. (A) Image at first visit to our hospital showed bilateral multiple tumorous and nodular shadows. (B) Image obtained 3 months after first visit showed improvement of opacities in the right lower lung field, and nodular shadows were partly enlarged in the left lung. (C) Image at 7 months after first visit showed extensive consolidation and enlargement of tumorous shadow in the left lung field. Nodular shadows were also present in the right hilum and the middle right lung field.

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  Fig. 2. Chest CT images of the patient. (A) Image at first visit to our hospital showed multiple tumors and nodules in the bilateral lung fields. (B) Image at 4 months after first visit showed shrinking of tumors in the bilateral lower lobes and an enlarged nodule in the left lung. (C) Image at 7 months after first visit showed nodules were enlarged mainly in the left lung and a tumorous shadow emerged in the right lower lobe.

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  Fig. 3. Pathological features of the right cervical lymph node. (A) HE staining revealed high endothelial venules (HEV) with thickened walls showing irregular dendritic branching and pale/clear cells increased around the HEV. Immunohistochemical staining revealed the atypical cells to be positive for CD3 (B), a marker of matured T cells, and CD10 (C), a marker of follicular helper T cells, and negative for CD20 (D), a marker of B cells.

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  Fig. 4. Pathological features of lung tissues from the surgical lung biopsy. (A) Panoramic image of HE staining showed a well-circumscribed nodular lesion. HE staining × 20 (B) and × 60 magnification (C) showed HEV and pale/clear cells similar to findings of the cervical lymph node.