February 2018

Zitong Zhao, Chee Leong Cheng, Jabed Iqbal, Li Yan Khor.
Department of Anatomical Pathology, Division of Pathology, Singapore General Hospital, Singapore.


Clinical History:
A 30-year-old Malay male patient presented with extensive bilateral cervical lymph node (LN) enlargement for one year. A fine needle aspiration (FNA) biopsy of right level IV cervical LN was performed for a diagnostic work-up.

FNA smears showed a cellular yield of large atypical cells in a polymorphous background (Figure 1). The background showed maturing lymphocytes, plasma cells, neutrophils and eosinophils (Figure 2). The large atypical cells had mono-, bi- and multilobate bizarre nuclei with clumped chromatin and scanty cytoplasm (Figure 3), which were rare in the cell block (Figure 4).

Fig 1 Feb 2018
Fig. 1 . Cervical lymph node, Diff Quik x 10
Fig 2 Feb 2018
Fig. 2. Cervical lymph node, Pap x 40
Fig 3 Feb 2018
Fig. 3. Cervical lymph node, Pap x 60
Fig 4 Feb 2018
Fig. 4. Cervical lymph node, cell block, H&E x 40

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