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. 2020 Jul 6:7:2374289520934089.
doi: 10.1177/2374289520934089. eCollection 2020 Jan-Dec.

Educational Case: Orbital B-Cell Lymphoma With Amyloid Deposition

Terrell E Jones  1 , Marie C De Frances  1 , Nidhi Aggarwal  2
Affiliations

Educational Case: Orbital B-Cell Lymphoma With Amyloid Deposition

Terrell E Jones et al. Acad Pathol. .

Abstract

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.1.

Keywords: amyloid; clinical features; extranodal lymphoma; hematopathology; orbital lymphoma; organ system pathology; pathology competencies; white cell disorders.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Computed tomography of the sinus/orbit showing ill-defined mass in left retrobulbar and superonasal soft tissue (red arrow).
Figure 2.
Figure 2.
H&E-stained sections of (A) lymphoplasmacytic aggregates with adjacent (B) acellular, amorphous eosinophilic material. C, A high-power image shows scattered plasma cells with the classic features of “clock-face” chromatin distribution and a perinuclear Hof. A plasma cell with a Russell body; an intracytoplasmic collection of immunoglobulin is identified (arrow). Scale bars measure 1 mm (A), 0.3 mm (B), and 25 µm (C), respectively.
Figure 3.
Figure 3.
Congo Red stained section (A) shows acellular material is congophilic and is (B) apple green birefringent upon polarization. Scale bars measure 1 mm.
Figure 4.
Figure 4.
Staining pattern of the lymphoid aggregate and plasma cells around the periphery: (A) CD20 stain highlights the B cells within the lymphoid follicle/aggregate, plasma cells at the periphery are negative; (B) CD19 is positive in both B cells and plasma cell areas; (C) CD138 highlights the plasma cells at the periphery; (D, E) lymphoid cells and plasma cells are negative for CD56 and cyclin D1. The plasma cells show (F) kappa light chain-restriction with (G) rare cells expressing the lambda light chain. Scale bars measure 0.5 mm.
Figure 5.
Figure 5.
Posttreatment computed tomography showing stable to minimally decreased mass size (blue arrow).
See this image and copyright information in PMC

References

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