5 year old male underwent a right cervical lymph node biopsy after a 2 week history of lymphadenopathy and a possible elevated CMV titer. The lymph node was signed out as “reactive lymphoid hyperplasia” The patient, however, developed increasing adenopathy and the slides were then reviewed by a second pathologist. The biopsy is now submitted for your review. Outside flow cytometric immunophenotypic studies were reported as “suggests a reactive process – no evidence of lymphoma – correlate with histology.” A CBC was unremarkable, the LDH was minimally elevated and he had normal IgG and IgM levels.

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Nodular lymphocyte predominant Hodgkin lymphoma