Progressive Formation of Germinal Centers with Multiple Nodule in The Lung

Author(s): Ahmet Dumanli, Gurhan Oz, Adem Gencer, Cigdem Ozdemir, Sule Cilekar, Aydin Balci

Enlarged lymph nodes in the head, neck, and axillary region are a common cause for patients to contact doctors. The most common cause of lymphadenopathy is infection and usually regresses with treatment. In the differential diagnosis of chronic lymphadenopathies, infection, lymphoproliferative diseases and progressive transformation of germinal centers should be considered. In this article, we aimed to discuss the patient with bilateral widespread nodular appearance in the cervical, supraclavicular, axillary, mediastinal lymph node and lungs. A 43-year-old female patient was referred for her mass in the neck and bilateral axillary region. Biopsy from the cervical region in the outer center was evaluated as an infection. In radiological imaging, lymph nodes were observed in the left cervical 15*11 mm, right supraclavicular 24*11 mm, left supraclavicular 18*11 mm, right axillary 11*21 mm, left axillary 27*18 mm, mediastinum 24*15 mm. In addition, extensive nodular lesion, the largest of which was 15 mm, was observed in both lungs. Excisional biopsy was performed from the left axillary region. Pathologically, progressive transformation of germinal centers was diagnosed. In the presence of lymphadenopathies that do not pass with medical treatment, an excisional biopsy should be performed and the diagnosis should be clarified for a definitive diagnosis.