A small cell variant of ALK-positive, CD8-positive anaplastic large cell lymphoma with primary subcutaneous presentation mimicking subcutaneous panniculitis-like T-cell lymphoma.

Published

Journal Article

ALK-positive anaplastic large cell lymphoma (ALK+ ALCL) is an uncommon non-Hodgkin's lymphoma of T-cell origin, the majority of which express CD4 and show frequent pan-T-cell antigen loss. While most cases of ALK+ ALCL have the common pattern characterized by anaplastic morphology with hallmark cells, a less common but well-recognized variant with a small cell pattern may pose a diagnostic challenge. We report a case of ALK+ ALCL with small cell morphology and CD8 subset restriction in a 53-year-old male patient who presented primarily with multiple recurrent subcutaneous nodules with histopathologic features simulating a subcutaneous panniculitis-like T-cell lymphoma (SPTCL). The case was initially diagnosed as SPTCL but was reconsidered as ALK+ ALCL when the incidental finding of CD30 positivity on a subsequent biopsy prompted an ALK immunostain, which turned out to be positive in the neoplastic T-cells. The diagnosis of ALK+ ALCL, small cell variant, was then confirmed by detection of an ALK gene rearrangement by FISH analysis. This report highlights a case of ALK+ ALCL with a deceiving clinical and histopathologic presentation, and emphasizes the value of immunohistochemical panel studies and genetic tests in such cases to avoid diagnostic errors.

Full Text

Duke Authors

Cited Authors

  • Wang, E; Papalas, J; Siddiqi, I; Stoecker, M; Rehder, C; Sebastain, S; Burchette, J; Huang, Q

Published Date

  • August 2011

Published In

Volume / Issue

  • 207 / 8

Start / End Page

  • 522 - 526

PubMed ID

  • 21763080

Pubmed Central ID

  • 21763080

Electronic International Standard Serial Number (EISSN)

  • 1618-0631

International Standard Serial Number (ISSN)

  • 0344-0338

Digital Object Identifier (DOI)

  • 10.1016/j.prp.2011.06.002

Language

  • eng