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. 2020 Mar 4;6(2):e79–e85. doi: 10.4158/ACCR-2019-0366

Fig. 2.

Fig. 2.

A, Generalized fat loss pattern in patient 2. B, Magnetic resonance images from a healthy control, who was a 28-year-old, healthy woman with a body mass index of 22.4 kg/m2 and normal fat distribution including (I) whole-body T1-weighted imaging, (II) face, head, and neck, axial T1, (III) trunk, axial T1, and (IV) pelvic region, axial T1. C, Whole-body magnetic resonance imaging showing adipose tissue is well preserved around the mons pubis and external genital region while fat tissue loss is noted in a generalized pattern in the scalp, mammary gland, visceral and subcutaneous abdomen, and extremities. A fluid-like signal is detected in the bone marrow. Retroorbital fat is protected. (I) Whole-body T1-weighted image, (II) head and neck, axial T1, (III) head and neck and shoulders, coronal T1, (IV) trunk and upper arms, axial T1, (V) trunk, axial T1, (VI) pelvic region, axial T1, (VII) pelvic region, coronal T1, (VII) back of the neck and upper trunk, sagittal T1, (IX) upper leg, axial T1, (X) lower leg, axial T1, (XI) retroperitoneal and perirenal fat, axial T1, and (XII) intraperitoneal and mesenteric fat residues, axial T1. D, Computed tomography scan with intravenous contrast showing multiple enlarged lymph nodes throughout the axillary, intraabdominal, and inguinal regions including the (I) thorax, coronal plane, (II) abdomen, coronal plane, (III) thorax, axial plane, (IV) abdomen, axial plane, and (V) inguinal region, axial plane. E, An excisional biopsy of the right cervical lymph node revealed neoplastic lymphoid infiltrate with a nodular pattern (more than 75%). These infiltrate cells were positively stained with CD20 and BCL-2. Additionally, many of these cells were BCL-6 and CD10 positive. There was no staining with CD5, CD38, or cyclin D1, while CD21 and CD23 were positive. Also, there were irregular dendritic cell networks in the areas showing a nodular pattern. The identified infiltrate was consistent with follicular lymphoma (low grade, or grade 1 to 2). (I) Neoplastic lymphoid infiltration showing nodular pattern. Hematoxylin and eosin stain, ×40. (II) CD20 positivity in the neoplastic cells, ×100. (III) BCL-2 positivity in the neoplastic cells ×100.