Male in his 60's with new cervical adenopathy & tonsillar enlargement. Flow cytometry of peripheral blood shows clonal B-cells with CLL phenotype. Tonsillar biopsy contains multifocal necrosis & a polymorphous B-cell infiltrate with areas of marked atypia:
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Ki-67 is elevated and MUM1+. Flow cytometry on tonsil shows no clonal B-cell or unusual T-cell population, but an inverted CD4/CD8 ratio. IHC for K/L light ⛓️ is polytypic. ISH for EBV is positive as is a heterophile antibody test performed on the patient.
@LucasMassoth @mvmd0908 Very nice teaching case. Thank you for sharing