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Presented by Dr. Pedram Argani and prepared by Dr. Harsimar Kaur
This is a 60 year old male with retroperitoneal mass.
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1. Question
This is a 60 year old male with retroperitoneal mass.
Correct
Answer: B
Histologic Description: The lesion is dominated by a prominent nodular lymphoid infiltrate, within are occasional atypical cells. In the fat surrounding the lesion, one can appreciate hyperchromatic nuclei that tend to be centered on fibrous septa. The lesion demonstrates MDM2 amplification by FISH.Differential Diagnosis: This lesion resembles Rosai Dorfman disease in that emperipolesis may be seen. However, Rosai Dorfman disease would not be characterized by the atypical enlarged nuclei in the fibrous stroma of the lesion. The presence of single atypical cells in the background of lymphoid tissue raise the possibility of Hodgkin’s disease; however, the lesional cells label for MDM2 but not for CD30 or CD15. The density of infiltrate suggests lymphoma; however, the lesion contains a mixture of B cells and T cells (the latter predominating).
Incorrect
Answer: B
Histologic Description: The lesion is dominated by a prominent nodular lymphoid infiltrate, within are occasional atypical cells. In the fat surrounding the lesion, one can appreciate hyperchromatic nuclei that tend to be centered on fibrous septa. The lesion demonstrates MDM2 amplification by FISH.Differential Diagnosis: This lesion resembles Rosai Dorfman disease in that emperipolesis may be seen. However, Rosai Dorfman disease would not be characterized by the atypical enlarged nuclei in the fibrous stroma of the lesion. The presence of single atypical cells in the background of lymphoid tissue raise the possibility of Hodgkin’s disease; however, the lesional cells label for MDM2 but not for CD30 or CD15. The density of infiltrate suggests lymphoma; however, the lesion contains a mixture of B cells and T cells (the latter predominating).
