The Hematologist

September-October 2017, Volume 14, Issue 5

A Woman With Hypergammaglobulinemia and Diffuse Lymphadenopathy

Girish Venkataraman, MD Assistant Professor
The University of Chicago Medicine, Chicago, IL
Megan Parilla, MD Pathology Resident
The University of Chicago Medicine, Chicago, IL

Published on: August 22, 2017

A 73-year-old woman with a history of autoimmune hepatitis presented with abdominal pain and fever. On further examination, the patient was noted to have hypergammaglobulinemia, elevated lactate dehydrogenase (LDH), and diffuse lymphadenopathy on imaging. An excisional biopsy of a superficial lymph node was performed. The images below are of a hematoxylin & eosin stain depicting architectural effacement by this proliferation of medium sized mononuclear cells (Figures A and B) containing numerous wisps of follicular dendritic cell meshworks (Figure C) and few scattered Epstein-Barr virus (EBV)+ cells (Figure D).

Low power H&E

Highest power

CD21 stain

EBV in situ stain
  

 

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