SHERRIE L. PERKINS
University of Utah Medical Center
Salt Lake City, UT
This is a 26 year-old man who presented with a sore throat and an asymmetrically enlarged right tonsil
(although both tonsils appeared enlarged). He had no significant past medical history. He noted a 3
pound weight loss and low-grade fever for the past week. Physical examination revealed several
enlarged cervical nodes and a palpable liver edge. A tonsillectomy was performed.
WILLIAM R. MACON
Mayo Clinic
Rochester, MN
An 81-year old female presented with epigastric pain and was subsequently found to have a solitary
splenic mass on abdominal CT scan. The patient was followed for 7 months, during which time the
splenic mass gradually enlarged and developed central necrosis. Splenectomy was then performed, and
the 200g spleen had a well-circumscribed 6.5 cm mass. A gross photo of the mass, low and high power
H&E stained images, EBV in situ hybridization and an EBV Southern blot are shown.
DENNIS D. WEISENBURGER
University of Nebraska Medical Center
Omaha, NE
The patient is a 61-year-old male with generalized lymphadenopathy who is otherwise asymptomatic. He
underwent a right inguinal lymph node biopsy. The phenotype of the lymphoid cells is as follows:
CD3-, CD5+, CD10-, CD20+, CD23-, CD43-, cyclin D1-.
ERIC D. HSI
Cleveland Clinic Foundation
Cleveland, OH
A 42 y.o. woman with a remote history of Hodgkin lymphoma in 1988 presented to a surgeon in October of
2003 with new adenopathy. The patient was well until 6 months prior to this when she developed
axillary lymphadenopathy. She also reported having night sweats for the last month and pruritis.
Other than the history of lymphoma, her past medical history was not significant. Physical
examination showed axillary, cervical, and supraclavicular lymphadenopathy. A cervical lymph node was
biopsied. H&E images and CD15 and CD30 immunostains are shown.
Shortly after the lymph node
biopsy was performed, a skin biopsy was also done. In the interim, a more detailed history and
physical was performed. Review of systems revealed a pruritic skin rash for 20 years and a dry cough.
Physical examination showed the previously mentioned lymphadenopathy and erythematous plaques on the
forearms and legs. A CBC was performed and showed a mild thrombocytosis (460 x 109/l) but was
otherwise normal.
