Question

Patient with general fatigue and tiredness. Primary clinical examination is uneventful.Normal TLC, DLC. No immature cells seen. Superficial discrete lymphnodes enlarged. On biopsy effaced architecture, indented nucleus and prominent nucleolus containing atypical cells. CD 10 & BCL-2 positive.

• A. Follicular
• B. Burkitts
• C. NHL
• D. Mycosis Fungoides

Answer 1

The Correct Option is A

The clinical presentation describes a patient with general fatigue and discrete lymph node enlargement, without the presence of immature cells and with normal total leukocyte count (TLC) and differential leukocyte count (DLC). The biopsy findings indicate effaced lymph node architecture, atypical cells with indented nuclei and prominent nucleoli, and positivity for CD10 and BCL-2 markers. These features are characteristic of Follicular Lymphoma.

• General Fatigue and Lymphadenopathy: Common in lymphoid malignancies such as Follicular Lymphoma.
• Effaced Architecture: Indicative of malignant transformation disrupting normal lymph node structure.
• Indented Nucleus and Prominent Nucleolus: Features of atypical lymphoid cells often seen in Follicular Lymphoma.
• CD10 and BCL-2 Positivity: These immunophenotypic markers are strongly associated with Follicular Lymphoma, aiding in its diagnosis.

Other options such as Burkitt’s Lymphoma and Mycosis Fungoides do not typically present with this combination of clinical and immunophenotypic features. Therefore, the most accurate diagnosis considering the discussed criteria is Follicular Lymphoma.