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A 64-year-old man presented with gastrointestinal bleeding and inguinal lymphadenopathy. His lymph node biopsy is presented in slide A. An IgM paraprotein was detected in his serum while a full blood count and film suggested iron deficiency with no lymphocytosis. A small bowel mass was detected on CT scan but the patient declined further investigations including bone marrow studies. He was treated based on the lymph node histology with transient resolution of the bleeding. He subsequently underwent resection of the small bowel mass due to recurrent bleeding. The histology of the small bowel mass is presented in slide B.
Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2017-204415_A/ and http://virtualacp.com/JCPCases/jclinpath-2017-204415_B/ …
Handling editor Iskander Chaudhry.
Contributors SdM conceived of the study and wrote the manuscript. MBA co-wrote the manuscript. K-SP and S-YN performed and provided the pyrosequencing data. SW provided the histopathology images and descriptions. L-MP assisted in the writing and performed a critical review of the manuscript. All authors read and approved the final manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Commissioned; internally peer reviewed.
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