May 2023 – Presented by Dr. Melissa Ha (Mentored by Dr. Ananya Datta Mitra)

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Clinical History

A 22-year-old female presents to the ER with one month of exertional dyspnea, worsening fatigue, neck swelling, unintentional weight loss, and intermittent chills and diaphoresis. Symptoms have reportedly worsened in the last week with more consistent chills, new cough, rhinorrhea, and diarrhea. CT imaging shows mediastinal, axillary, and cervical lymphadenopathy as well as splenomegaly. HIV screen is positive.

An axillary lymph node is excised and submitted for workup:

   

Sections of the axillary lymph node show effaced architecture with sheets of large, atypical cells with the following immunohistochemical profile:

Tissue flow cytometry analysis is negative for monoclonal B-cells and there are no increased blasts.