Figure 1.

(A–F). Bone marrow biopsy and aspirate findings in leukemic phase of high grade diffuse large B cell lymphoma (DLBCL) with t(8;14). (A) The normal hematopoietic elements in the bone marrow biopsy were almost completely replaced by sheets of atypical lymphocytes (Hematoxylin and Eosin, ×400). (B) Aspirate smears showed numerous large atypical lymphocytes with round and irregular nuclei, dispersed nuclear chromatin, prominent small nucleoli, and moderate to abundant agranular basophilic cytoplasm (Wright Giemsa, × 1000). (C) CT scan of orbits showing orbital recurrence of DLBCL. Recurrence is seen beneath the left lateral rectus muscle (see white arrows). There was also destruction of the posterior wall of the orbit and evidence of left orbital proptosis. (D) PET scan showing multiple hyper metabolic masses involving right and left leg musculature. In the right mid-thigh, whereas in the left leg just above the knee. A mass in medial right gastrocnemius muscle had a SUV of 10.7. (E) Focal hyper metabolism in left posterior paraspinal musculature, with a 2.3 cm nodule and SUV 7.4 at the L4 vertebral level was noted (see arrow). (F). Good response was demonstrated by PET scan, after local radiotherapy except for one area on left lower thigh. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]