Hypercalcemia in Small Lymphocytic Lymphoma with an Elevated Parathyroid Hormone-Related Peptide Associated with Early Richter Transformation

Figure 1

H&E sections of the lymph node excisional biopsy before transformation, demonstrating small round B-lymphocytes with clumped chromatin and rare mitosis (1a); Ki67 showing a low proliferation index (1b). 1c and 1d demonstrate increased cell size with numerous mitotic figures (arrowheads) and a significantly increased proliferation index by Ki67, respectively, at the time of early transformation. All images are taken at 400X magnification.

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