#00062972

A 52-year-old male presented with progressive neurological symptoms of the lower limbs associated with significant weight loss and drenching night sweats. Splenomegaly was detected on clinical examination, but no enlarged lymph nodes were palpable. Hemoglobin was 74 g/L, platelet count was 81 x 109/L and LDH was elevated at 709 U/L. Biopsies of the right gastrocnemius muscle and the right sural nerve were obtained for further evaluation of the patient’s neurological symptoms. H&E stain demonstrated a lymphocytic infiltration which comprised of large cells that were positive for CD20 and CD10 (panel A-C; right gastrocnemius muscle, original magnification × 10, panel D; right sural nerve, original magnification × 10, panel E; large lymphoid cells stained by CD10, original magnification × 40). The features were consistent with diffuse large B-cell lymphoma.