The patient proceeded initially to ultrasound guided left axillary nodal core biopsy, and subsequently excision biopsy of a left axillary node.

The histology and immunohistochemistry together confirmed T-cell lymphoma with some features consistent with angioimmunoblastic lymphoma.

The patient subsequently has completed intensive chemotherapy (CHOP regime) with evidence of disease response namely reduction in spleen and nodal disease volume. He is currently under follow up.

Case courtesy of Dr Joshua Bell, Dr Rachel Hyland and Dr Sarah Swift.