MEETING No. 26, DECEMBER, 13rd, 2000, SAN CARLO HOSPITAL, MILANO

Case 1
Case 2
Case 3
Case 4
Case 5

Case 2

"CERVICAL LYMPHADENOPATHY"
P. INCARDONA - S. Matteo Hospital, Pavia
(Pictures from viewing slides the Pavia group)

Clinical history: in January 2000 a clinically a symptomatic 22y.o. man presents in other hospital because of right cervical lymphadenopathy. Blood tests are in the normal range.
EBV and Toxoplama antibodies are negative. Abdominal ultrasound, chest X-ray and rhynoscopy are all negative. A lymph node biopsy is performed and a “cat scratch disease” diagnosis is made. In October 2000 because of bilateral and sub-mandibular lymphadenopathy he is admitted to the Day Hospital, S. Matteo Hospital in Pavia where a FNA and a biopsy of the lymph node are performed.
Cytological description: the smears show a pleomorphic population consisting of eosinophils, lymphocytes and mononuclear cells with large and clear cytoplasm.
Biopsy microscopic description: the architecture of the lymph node is maintained; there is capsular fibrosis and peri-adenitis; the sinuses are markedly enlarged by a rich cellular infiltrate, which consists mainly of medium sized cells with indented nuclei, fine membrane and chromatin; nucleoli are not conspicuous. There is focal necrosis (pict. 1) - (pict. 2) - (pict. 3)
Immunohistochemistry:

• LCA -
• CD79a -
• Bcl2 -
• CD3 -
• CD15 -
• CD30 -
• LN5 -
• PGM1 -
• CD14 -
• S100 + (pict. 4)
• CD1a + (pict. 5)
• LN3 +
• MT1 / CD43 +
• Catepsina D ed E -
• Mitotic index (Mib1/Ki67 L.I.) less than 5%

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5

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