Anaplastic large cell lymphoma ALK+ (ALCL ALK+)
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2011, Vol 28, Issue 6
Abstract
A previously healthy 24-year-old man presented at the emergency department with cervical lymphadenopathy, dyspnea and leukocytosis. The patient also complained of weight loss and night sweats during the preceding two months. Physical examination revealed bilateral crepitations and palpable bilateral cervical and supraclavicular lymphadenopathy. At room air ABGs (arterial blood gas) were as follows: pH=7.4, PO2=68.5 mmHg, PCO2=30.4 mmHg, HCO3 -=20.3 mEq/L, SpO2=95%. His full blood count was as follows: Ht=40.7%, Hb=13.5 g/dL, RBC=4.88×1012/L, WBC=33.95×109/L (neutrophils=68%, lymphocytes=15%, monocytes=4%, atypical lymphocytes=13%), PLT=456×109/L. Serum biochemistry showed elevated LDH levels (358 IU/L). Peripheral blood cell morphology is shown in figure 1. The bone marrow aspiration revealed the presence of atypical lymphoid cells, similar to those found in the peripheral blood, albeit at a low percentage (fig. 2). Immunophenotypic study showed an expression of cytCD3, CD4, CD2, CD30 to 83% of lymphocytes while being negative for CD7, CD5 and sCD3. CT scan of the thorax revealed multiple enlarged mediastinal lymph nodes, interstitial lung disease and bilateral pleural infusions. A cervical lymph node biopsy was performed that revealed the presence of large and medium-sized cells with round or kidney-shaped nuclei and prominent nucleoli (fig. 3). Immunohistochemistry was as follows: 100% positivity for LCA, ALK, CD30, EMA, CD43 CD2, CD4, CD25, 10% positivity for granzyme B, 20% positivity for CD3 and TIA1. Blood and bone marrow immunophenotype and lymph node histology were diagnostic.
Authors and Affiliations
L. PAPAGEORGIOU, V. KARALI, A. KANELLOPOULOS, G. GAINAROU, P. FLEVARI, K. PETEVI, TH. DALAGIORGOS, E. KOUTSI, Z. GALANI, M. ANGELOPOULOU, T. VASSILAKOPOULOS, J. MELETIS
Keywords
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