Needle core biopsy of 1.5 cm lymph node in the abdomen at porta hepatis. Numerous small and large nodes are present. Flow cytometry shows peripheral blood contaminated specimen, lymphocytes population is 97 % of total leukocytes and consists of T-cells helper and suppressor immunoph and poly B cells, not suggestive for B cell lymphoproliferative neoplasm. Immuno outcomes: CD3, CD5, CD43 many positive T-cells. CD20, CD79A many positive B cells. CD23, Bcl-2 some positive. Cyclin D1: rare positive only CD10 negative.
Diagnosis: negative for malignancy. Question: I have a history of sibling lymphoma and I have the epstein barr virus. Should they consider mantle cell lymphoma? Needle core biopsy through endoscope may not be definitive. Excisional would have been better. Lymphoma symptoms are present. Primary biliary cholangitis was also diagnosed before five years. Lymphocytic colitis and erosions in the stomach are also found. Should I ask for more testing for lymphoma?
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Hereby, I am giving my opinion for your case. You are having ebstein bar virus infection. This virus can lead to hepatitis development and enlarged lymph nodes. You are right on your suspicion that multiple enlarged lymph nodes raised suspicion towards malignancy especially lymphoma. But the main thing is biopsy is considered conclusive and your flow cytometry report is clearly suggestive of non-malignant lesion that is polyclonal cells are present. So these reports are not suggestive of any lymphoma. You have mentioned diagnosis as primary biliary cholangitis, so in this autoimmune disease, liver enzymes can be elevated. In this disease, over the time cirrhosis also can be developed. No need of repeat biopsy just now as per the mentioned report. Consult a gastroenterologist for primary biliary hepatitis. Take care.
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