Unusual pleomorphic cells in axillary lymph node.

A man in his 60s with a history of superficial gastric cancer and stage IIIB intestinal adenocarcinoma since 2 years, untreated due to systemic symptoms of myelofibrosis, on follow-up CT scan showed left pleural effusion and axillary adenopathy. Clinical diagnosis was gastrointestinal cancer metastasis versus lymphoma. Pleural fluid cytologic smears were negative for malignancy. Excisional biopsy of an axillary lymph node was performed. 1. Gastric or intestinal cancer metastasis. 2. Lymph node granulomatous disease. 3. Hodgkin’s lymphoma. 4. Nodal extramedullary haematopoiesis (EMH). 5. Lung cancer metastasis. EMH is the production of erythroid and myeloid progenitor cells outside of the bone marrow.1 It can occasionally occur in lymph nodes, frequently associated with underlying haematopoietic disorders or neoplasms.1 2 In very rare cases, it has been reported in patients treated with granulocyte colony-stimulation factor (G-CSF) during chemotherapy and radiotherapy for breast cancer and also in late-stage tumours.3 …