Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2014.004
Autopsy and Case Reports
Article / Autopsy Case Report

Unusual clinical presentation of anaplastic large cell lymphoma

Fernando Peixoto Ferraz de Campos; Maria Claudia Nogueira Zerbini; Aloisio Felipe-Silva; Angélica Braz Simões; Silvana Maria Lovisolo; Leonardo Gomes da Fonseca; Lorena Laborda

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Abstract

Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders—mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.
 

Keywords

Lymphoma, Large-Cell, Anaplastic, Acquired Immunodeficiency Syndrome, Fever of Unknown Origin, Autopsy

References

Stein H, Mason DY, Gerdes Jet al. The expression of Hodgkin’s disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cell. Blood. 1985;66:3681-95.

Mason DY, Harris NL, Delsol G, et al. Anaplastic large cell lymphoma, ALK-negative. In: Swerdlow SCE, Campo E, Harris NL, et al., editors. WHO classification of tumors of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 317-9.

Delson G, Falini B, Muller-Hermelink HL, et al. Anaplastic large cell lymphoma, ALK-positive. In: Swerdlow SCE, Campo E, Harris NL, et al., editors. WHO classification of tumors of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 312-6.

Jafe ES. Anaplastic large cell lymphoma: the shifting sands of diagnostic hematopathology. Mod Pathol. 2001;14:219-28. http://dx.doi.org/ [https://doi.org/10.1038/modpathol.3880289]

Arzoo KK, Bu X, Espina BM, Serevinatne L, Nathwani B, Levine AM. T-cell lymphoma in HIV-infected patients. J Acquir Immune Defic Syndr. 2004;36:1020-7. http://dx.doi.org/ [https://doi.org/10.1097/00126334-200408150-00004]

Mosunjac MB, Sundstrom BJ, Mosunjac MI. Unusual presentation of anaplastic large cell lymphoma with clinical course mimicking fever of unknown origin and sepsis: Autopsy study of five cases. Croat Med J. 2008;49:660-8. http://dx.doi.org/ [https://doi.org/10.3325/cjm.2008.5.660]

Campos FPF, Felipe-Silva A, Zerbini MCN. Anaplastic large cell lymphoma ALK-negative clinically mimicking alcoholic hepatitis - a review. Autopsy Case Rep [Internet]. 2013;3(3):11-9. http://dx.doi.org/ [https://doi.org/10.4322/acr.2013.023]

Genet P, Chaoui D, Masse Vet al. Anaplastic large cell lymphoma occurring in an HIV-positive patient. Case Rep Hematol. 2012; Article ID 180204. http://dx.doi.org/ [https://doi.org/10.1155/2012/180204]

Taniai H, Furusyo N, Murata Met al. A case report of human immunodeficiency virus-associated anaplastic lymphoma kinase protein-negative anaplastic large cell lymphoma. SpringerPlus. 2013;2:400-5.

Biggar RJEngels EAFrisch MGoedert JJ. Risk of T-cell lymphomas in persons with AIDS. J Acquir Immune Defic Syndr. 2001;26(4):371-6. http://dx.doi.org/ [https://doi.org/10.1097/00126334-200104010-00015]

Castillo J, Beltran BE, Bibas Met al. Prognostic factors in patients with HIV-associated peripheral T-cell lymphoma: a multicenter study. Am J Hematol. 2011;86:256-61. http://dx.doi.org/ [https://doi.org/10.1002/ajh.21947]

Castillo J, Perez K, Milani C, Dezube BJ, Pantanowitz L. Peripheral T-cell lymphomas in HIV-infected individuals: a comprehensive review. J HIV Ther. 2009;14:34-40.

Perez K, Castillo J, Dezube BJ, Pantanowitz L. Human immunodeficiency virus-associated anaplstic large cell lymphoma. Leuk Lymphoma. 2010;51:430-8. http://dx.doi.org/ [https://doi.org/10.3109/10428190903572201]

Kumar S, Wanchu A, Sharma Aet al. Spinal cord compression caused by anaplastic large cell lymphoma in an HIV infected individual. J Cancer Res Ther. 2010;6:376-8. http://dx.doi.org/ [https://doi.org/10.4103/0973-1482.73358]

Harada Y, Yamada S, Murakami Set al. Ki-1 lymphoma with nodular involvement in liver and spleen: possible role of cytokines in systemic manifestation of fever and leukocytosisDig Dis Sci. 2000;45:2240-6.

Janik JE, Morris JC, Pittaluga Set al. Elevated serum-soluble interleukin-2 receptor levels in patients with anaplastic large cell lymphomaBlood. 2004;104:3355-7. http://dx.doi.org/ [https://doi.org/10.1182/blood-2003-11-3922]


 


Publication date:
01/13/2016

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