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Rafizadeh SM, Ghahvehchian H, Rajabi MT, Heidari M, Rahmanikhah E. Anaplastic Large Cell Lymphoma With Intraocular or Ocular Adnexal Involvement: A Case Report and Systematic Review. Ophthalmic Plast Reconstr Surg 2024; 40:235-244. [PMID: 37721309 DOI: 10.1097/iop.0000000000002520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
PURPOSE To review the existing literature on patients with anaplastic large cell lymphoma (ALCL) affecting the globe and/or ocular adnexa, and to present a report documenting the clinical course of a patient with ALCL that involved their globe and ocular adnexa. METHODS PubMed, Scopus, and Google scholar were systematically searched for all cases of ALCL involving intraocular or adnexal ocular structures from inception to May 2023. Moreover, a new reported case added to the cases found in searches. RESULTS The review identified 1680 studies, with 8 meeting inclusion criteria. A total of 9 patients were included with a mean age of 29.7 years (median: 30.0, range: 1.3-48). Primary ALCL was present in 5/9 (55.6%) patients. The most common ophthalmic manifestations included periorbital swelling (5/8), chemosis (5.8), and decreased vision (5/7). Misdiagnoses were initially made in 3 patients, and the lag time to correct diagnosis from 3 weeks to 3 months. CD30 expression was positive in all cases, and 6/9 patients were positive for anaplastic lymphoma kinase, resulting in 6/9 patients being diagnosed with anaplastic lymphoma kinase-positive ALCL. In terms of management modalities, chemotherapy was administered in 8/9 patients, while radiation therapy was utilized in 4/9 patients, and 2 underwent autologous stem cell transplantation. Five (55.6%) patients succumbed to ALCL while 4 (44.4%) were alive and disease-free at the last follow-up. The median times from the initial presentation of ALCL to death, ophthalmic presentation to death, and diagnosis to death were 4.12 months (range: 1.1-168.0), 2.62 months (range: 1.1-144), and 4.00 months (range: 0.10-168), respectively. The median follow-up duration was 21.0 months (range: 1.1-168.0). CONCLUSIONS ALCL involving the globe and ocular adnexa is a rare and highly malignant tumor that can mimic benign clinical conditions. Early biopsy and aggressive treatment with chemotherapy regimens such as CHOP and radiation therapy may be useful.
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Affiliation(s)
- Seyed Mohsen Rafizadeh
- Department of Oculofacial Plastic and Orbital Surgery, Farabi Comprehensive Center of Excellence in Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghahvehchian
- Department of Oculofacial Plastic and Orbital Surgery, Farabi Comprehensive Center of Excellence in Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
- Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taher Rajabi
- Department of Oculofacial Plastic and Orbital Surgery, Farabi Comprehensive Center of Excellence in Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Heidari
- Department of Oculofacial Plastic and Orbital Surgery, Farabi Comprehensive Center of Excellence in Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaham Rahmanikhah
- Department of Oculofacial Plastic and Orbital Surgery, Farabi Comprehensive Center of Excellence in Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
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Ali Y, Naeem UH, Rahman HU, Khan S, Amin S, Ahmad K, Durrani H. Anaplastic Large Cell Lymphoma of the Spine: Report of a Rare Case. Cureus 2024; 16:e54602. [PMID: 38524078 PMCID: PMC10958758 DOI: 10.7759/cureus.54602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
This abstract discusses a rare case of anaplastic large cell lymphoma (ALCL) involving the cervical and dorsal spine in a 17-year-old female. ALCL is a distinct subtype of lymphoma characterized by abnormal proliferation of lymphocytes and is divided into ALK-positive and ALK-negative subtypes. Spinal involvement in ALCL is uncommon, particularly in the cervical and dorsal regions. The patient presented with persistent fever, weakness, and delayed onset of severe neck pain. Diagnosis involved imaging, bone marrow biopsy, and lymph node biopsy. Treatment strategies for ALCL typically involve a multimodal approach, including chemotherapy, radiotherapy, and targeted therapy. However, due to the rarity of spinal involvement, treatment decisions are based on extrapolation from other ALCL cases. Prognosis is influenced by disease stage and ALK status, but specific outcomes for spinal involvement remain poorly established. This case emphasizes the need for considering lymphoma in patients with unexplained symptoms and abnormal imaging findings. It highlights the importance of further research to improve the understanding and management of ALCL with spinal involvement.
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Affiliation(s)
- Yasir Ali
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Ume Hani Naeem
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Hefz U Rahman
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Sajid Khan
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Shafqat Amin
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Kamran Ahmad
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
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Zhong Y, Xie J, Chen J, Ping L, Zang S, Zhang Y, Feng Y, Huang Y. Extranodal NK/T-Cell Lymphoma Predominantly Composed of Anaplastic Cells: A Frequently Misdiagnosed and Highly Aggressive Variant. Am J Surg Pathol 2024; 48:174-182. [PMID: 37982454 DOI: 10.1097/pas.0000000000002156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Extranodal NK/T-cell lymphoma (ENKTL) is a non-Hodgkin lymphoma associated with the Epstein-Barr virus that primarily affects individuals in East Asia and indigenous populations in Central and South America. Morphologically, ENKTL typically consists of medium-sized cells or a combination of small and large cells. This report presents 10 cases characterized by predominantly anaplastic cells with diffuse expression of CD30, resembling anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-negative ALCL) and demonstrating highly aggressive behavior. The cohort included 9 males and 1 female, ranging in age from 29 to 65 years (median age: 47 y). Eight patients presented with nasal disease, while 2 had non-nasal disease. Five patients had stage I/II disease, and the remaining 5 had stage III/IV disease. Morphologically, necrosis was observed in 9 cases, angiocentric-angiodestructive growth in 3 cases, and pseudoepitheliomatous hyperplasia in 2 cases. Anaplastic cells predominated in all cases, with some displaying eccentric, horseshoe-shaped, or kidney-shaped nuclei (referred to as "Hallmark" cells). The morphology profile was monomorphic in 3 cases and polymorphic in 7 cases. Immunohistochemically, all cases tested positive for cytotoxic granule markers (TIA1 and granzymeB) and Epstein-Barr virus-encoded RNA. Cytoplasmic expression of CD3ε and CD56 was observed in 9 of 10 cases. Interestingly, most cases (7 of 8) exhibited variable expression of MuM1, ranging from 10% to 90%. All cases showed diffuse positivity for CD30 but were negative for ALK, resulting in 3 cases being initially misdiagnosed as ALK-negative ALCL. Compared with nonanaplastic cases, anaplastic cells predominant ENKTL had a significantly higher frequency of "B" symptoms, bone marrow involvement, hemophagocytic lymphohistiocytosis, and higher Ki67 proliferative index. These findings provide valuable information for pathologists, expanding their understanding of the cytologic spectrum of ENKTL. This rare variant of ENKTL, characterized by the predominance of anaplastic cells and diffuse CD30 expression, exhibits high aggressiveness and should be differentiated from ALK-negative ALCL. Awareness of this uncommon variant is crucial in preventing misdiagnosis and ensuring the timely initiation of therapy.
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Affiliation(s)
- Yujia Zhong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Jianlan Xie
- Department of Pathology, Beijing Friendship Hospital, Capital Medical University
| | - Jierong Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Liqin Ping
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Shengbing Zang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Yingchun Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Yanfen Feng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
| | - Yuhua Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
- Department of Pathology, Sun Yat-sen University Cancer Center
- Department of Pathology, Sun Yat-sen University Cancer Center Gansu Hospital, Lanzhou, Gansu, Chiina
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El farissi MAA, Dehneh Y, Kada A, Dahamou M, Khoulali M, Oulali N, Moufid F. Uncommon spinal involvement of ALK-positive anaplastic large cell lymphoma: A pediatric case report and literature review. Radiol Case Rep 2024; 19:341-345. [PMID: 38028318 PMCID: PMC10663636 DOI: 10.1016/j.radcr.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare variety of non-Hodgkin lymphoma that primarily affects children and young adults and is caused by the fusion of the nucleophosmin 1 and ALK genes, which turns on several signalling pathways. Despite the fact that ALCL frequently affects lymph nodes and extranodal sites, involvement of the central nervous system (CNS) is quite uncommon, with symptoms like pain and fever. The spinal localization may result in neurological impairments. T1WI hypointense lesions with T2WI hyperintensity can be observed on MR images, while bone sequestra can be seen in CT scans. The gold standard for diagnosis is still histology, though. Based on distinctive morphological characteristics, immunohistochemical staining can differentiate ALK-positive ALCL from other ALCLs. The prognosis for ALK-positive ALCL is typically better than ALK-negative ALCL, and treatment options include surgery followed by chemotherapy. ALK inhibitors and CAR-T cell therapy are 2 newly developed targeted treatments that have the potential to improve results. This case report illustrates the rarity of CNS ALCL and the difficulties in diagnosis and treatment by describing a 16-year-old female patient with ALCL affecting the thoracic spine and spreading to the mediastinum and surrounding tissue.
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Affiliation(s)
- Mohammed Al amine El farissi
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Youness Dehneh
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Amine Kada
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Mohamed Dahamou
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Mohamed Khoulali
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Noureddine Oulali
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Faycal Moufid
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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Ahuja R, Patel V, Mallick S, Damle N, Sharma A, Gupta V. Anaplastic Lymphoma Kinase (ALK)-negative systemic anaplastic large cell lymphoma presenting as zosteriform skin nodules. Indian J Dermatol Venereol Leprol 2023; 0:1-5. [PMID: 38031677 DOI: 10.25259/ijdvl_1166_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 09/17/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Rhea Ahuja
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Varniraj Patel
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | | | | | - Atul Sharma
- Department of Medical Oncology, AIIMS, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
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Ud Din N, Rahim S, Ansar Z, Ahmed A, Ahmad Z. Anaplastic Large-cell Lymphoma Involving Gastrointestinal Tract: A Clinicopathologic Study of 25 Cases of a Rare Tumor at a Rare Site. Int J Surg Pathol 2023; 31:1195-1205. [PMID: 36514288 DOI: 10.1177/10668969221137518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background. Anaplastic large-cell lymphoma (ALCL) is an uncommon lymphoma divided into anaplastic lymphoma kinase (ALK) positive, ALK negative, and breast implant-associated (BIA) ALCL. Gastrointestinal tract involvement is very rare and may be difficult to diagnose. Its recognition is crucial as prognostic ramifications are different. Objectives. To describe clinicopathological features of ALCL involving the gastrointestinal tract. Materials and Methods. Slides were reviewed. Diagnosis was confirmed. Histological and immunohistochemical features were described. Results.Twenty-five tumors were diagnosed during the study period. Ages ranged from 14 to 65 years (mean 41 years). Mean age for ALK-negative and ALK-positive patients were 49 and 17 years, respectively. Twenty-one were males and 4 were females. Eighteen involved small intestine. Mean tumor size was 4.2 cm. All showed diffuse sheets of large anaplastic cells with pleomorphic nuclei, abundant pink cytoplasm, and strong positivity for CD30. Epithelial membrane antigen was positive in 17 tumors and keratin was negative in all. Eighteen tumors were ALK negative. Out of 14 patients with follow-up, 12 died within a few months of diagnosis. Seven had stage IE, 5 had stage IIE, and 2 had stage IV disease. Two patients were alive at 35 and 60 months. Twelve received chemotherapy. Conclusion. A marked male predominance was noted. Small intestine was the commonest site of involvement. Majority were ALK negative. ALK-negative tumors occurred in older patients and ALK positive in younger patients. Prognosis was poor. ALCL should be included in the differential diagnosis of anaplastic epithelioid cell neoplasms in the gastrointestinal tract.
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Affiliation(s)
- Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shabina Rahim
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Zeeshan Ansar
- Section of Molecular Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Arsalan Ahmed
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Zubair Ahmad
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Cefai E, Montanaro G, Mercieca C. Anaplastic bone lymphoma presenting as isolated back pain. BMJ Case Rep 2023; 16:e254516. [PMID: 37491120 PMCID: PMC10373682 DOI: 10.1136/bcr-2022-254516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
A previously healthy man in his late 20s presented with a 4-week history of insidious back pain and raised inflammatory markers. Various specialists were involved in his care including general physicians, orthopaedic surgeons and rheumatologists. After numerous investigations including imaging and two bone biopsies, an unexpected diagnosis of anaplastic large cell lymphoma emerged. This case illustrates the importance of investigating back pain with red flags thoroughly using different imaging modalities and where indicated a bone biopsy.
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Affiliation(s)
- Erika Cefai
- Rheumatology, Mater Dei Hospital, Msida, Malta
- Medicine, Mater Dei Hospital, Msida, Malta
| | | | - Cecilia Mercieca
- Rheumatology, Mater Dei Hospital, Msida, Malta
- Medicine, Mater Dei Hospital, Msida, Malta
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8
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Weeraddana P, Weerasooriya N, Elkabbani R, Mohamed Jiffry MZ, Nisha N, Sandhu MK. Anaplastic Large-Cell Lymphoma (ALCL) First Manifested as a Rapidly Progressive Acute Respiratory Failure (RF): Lymph Node Biopsy Negative Presentation Posing a Diagnostic Challenge. Cureus 2023; 15:e37619. [PMID: 37197117 PMCID: PMC10184955 DOI: 10.7759/cureus.37619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 05/19/2023] Open
Abstract
Anaplastic large-cell lymphoma (ALCL) is an aggressive subtype of non-Hodgkin lymphoma. There are two forms of ALCL: primary and secondary. Primary can be systemic, affecting multiple organs, or cutaneous, affecting mainly the skin. A secondary form occurs when another lymphoma undergoes an anaplastic transformation. ALCL rarely presents as initial symptoms of respiratory failure. In most of these situations, the trachea or bronchial involved with an obstruction was present. We present an unusual case of ALCL where the patient rapidly progressed to acute hypoxic respiratory failure with a patent bronchus and trachea. Unfortunately, the patient rapidly deteriorated and died before diagnosis. Only upon at autopsy, it was found that his lung parenchyma was diffusely involved with ALCL. The autopsy report showed that the patient had CD-30 anaplastic lymphoma kinase (ALK)-negative ALCL diffusely involving all lung fields.
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Affiliation(s)
| | | | | | | | - Nepal Nisha
- Internal Medicine, Danbury Hospital, Danbury, USA
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Miranda JA, Elías MB, Mazzotta MM, Zalazar ÉV. Metastatic anaplastic large cell lymphoma of the omentum presenting as an ulcerated nodule on the back. Indian J Dermatol Venereol Leprol 2023; 89:106-109. [PMID: 36331851 DOI: 10.25259/ijdvl_596_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/01/2022] [Indexed: 02/03/2023]
Affiliation(s)
| | - María Belén Elías
- Department of Dermatology, Universidad Nacional de Córdoba, Argentina
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Chen HY, Kuo YC, Cheng WC, Chen WC. A rare presentation of anaplastic large cell lymphoma as a cavitary pulmonary mass with hypercalcemia. Thorac Cancer 2022; 13:2398-2400. [PMID: 35811296 PMCID: PMC9376169 DOI: 10.1111/1759-7714.14571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
Cavitary lung lesions found on chest imaging may point to various diseases. These lesions may be caused by numerous etiologies, such as infection, inflammatory diseases, or malignancy. Thus, its etiology may be challenging to differentiate using imaging alone. Differential diagnoses are created using a combination of clinical symptoms, medical history, laboratory results, and physical examination. Primary pulmonary lymphoma and anaplastic large cell lymphoma (ALCL) are rare differentials. Here, we report a case of ALCL that initially presented with back pain, intermittent fever, hemoptysis, hypercalcemia, and bilateral multiple cavitary lung nodules. Because a cavitary pulmonary mass with sustained hypercalcemia is commonly seen in patients with squamous cell carcinomas or pulmonary tuberculosis, patients with ALCL may be misdiagnosed and undergo delayed treatment. This study highlights that ALCL should be considered in patients presenting with a cavitary pulmonary mass and hypercalcemia.
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Affiliation(s)
- Hsu-Yuan Chen
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chu Kuo
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Chien Cheng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Cheng Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Anaplastic Large Cell Lymphoma: Molecular Pathogenesis and Treatment. Cancers (Basel) 2022; 14:cancers14071650. [PMID: 35406421 PMCID: PMC8997054 DOI: 10.3390/cancers14071650] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Anaplastic large cell lymphoma is a rare type of disease that occurs throughout the world and has four subtypes. A summary and comparison of these subtypes can assist with advancing our knowledge of the mechanism and treatment of ALCL, which is helpful in making progress in this field. Abstract Anaplastic large cell lymphoma (ALCL) is an uncommon type of non-Hodgkin’s lymphoma (NHL), as well as one of the subtypes of T cell lymphoma, accounting for 1 to 3% of non-Hodgkin’s lymphomas and around 15% of T cell lymphomas. In 2016, the World Health Organization (WHO) classified anaplastic large cell lymphoma into four categories: ALK-positive ALCL (ALK+ALCL), ALK-negative ALCL (ALK−ALCL), primary cutaneous ALCL (pcALCL), and breast-implant-associated ALCL (BIA-ALCL), respectively. Clinical symptoms, gene changes, prognoses, and therapy differ among the four types. Large lymphoid cells with copious cytoplasm and pleomorphic characteristics with horseshoe-shaped or reniform nuclei, for example, are found in both ALK+ and ALK−ALCL. However, their epidemiology and pathogenetic origins are distinct. BIA-ALCL is currently recognized as a new provisional entity, which is a noninvasive disease with favorable results. In this review, we focus on molecular pathogenesis and management of anaplastic large cell lymphoma.
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Roy PG, Yan Z, Nigam S, Maheshwari K. Aesthetic breast surgery: putting in context-a narrative review. Gland Surg 2021; 10:2832-2846. [PMID: 34733731 DOI: 10.21037/gs-20-892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/12/2021] [Indexed: 01/13/2023]
Abstract
Objective This review article summarises the latest evidence for commonly undertaken procedures in aesthetic breast surgery with a focus on key principles of breast augmentation, reduction, and mastopexy. The paper also outlines various approaches and controversies as well as complications such as breast implant associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant illness (BII) which are increasingly being recognised and becoming a challenge to manage. Background Changing trends of aesthetic breast surgery over the decades has warranted a continuous evolution of this field. The ability to deliver safe and appropriate care is dependent upon sound reconstructive principles and proper training. The lack of uniformity in either is a cause of concern. The impact of social media and changing perception of body image can also no longer be overlooked in the field of aesthetics and reconstruction. Methods Review of literature including recent journals, textbook chapters, online databases like PubMed, and current government and surgical society guidelines. Conclusions Breast reconstruction is based on sound surgical principles and it is imperative to follow these for the practice of this speciality. There are two important issues that revolve around this aspect of surgery. First relates to the urgent need to invest time and effort in improving regulations and outcomes in the cosmetic surgery industry. Second, it is crucial to promote and prioritize the development and training in this field as the principles of aesthetic breast surgery underpins oncoplastic breast surgery for management of cancer.
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Affiliation(s)
- Pankaj G Roy
- Department of Breast Surgery, Oxford University Hospital NHSFT, Oxford, UK
| | - Zhiyan Yan
- Department of Breast Surgery, Oxford University Hospital NHSFT, Oxford, UK
| | - Shashank Nigam
- Department of Breast Surgery, Oxford University Hospital NHSFT, Oxford, UK
| | - Kavish Maheshwari
- Department of Plastic Surgery, Bedfordshire Hospitals NHS Trust, Bedfordshire, UK
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Wurster KD, Costanza M, Kreher S, Glaser S, Lamprecht B, Schleussner N, Anagnostopoulos I, Hummel M, Jöhrens K, Stein H, Molina A, Diepstra A, Gillissen B, Köchert K, Siebert R, Merkel O, Kenner L, Janz M, Mathas S. Aberrant Expression of and Cell Death Induction by Engagement of the MHC-II Chaperone CD74 in Anaplastic Large Cell Lymphoma (ALCL). Cancers (Basel) 2021; 13:cancers13195012. [PMID: 34638496 PMCID: PMC8507667 DOI: 10.3390/cancers13195012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Anaplastic large cell lymphoma (ALCL) is a lymphoid malignancy considered to be derived from T cells. Currently, two types of systemic ALCL are distinguished: anaplastic lymphoma kinase (ALK)-positive and ALK-negative ALCL. Although ALK+ and ALK− ALCL differ at the genomic and molecular levels, various key biological and molecular features are highly similar between both entities. We have developed the concept that both ALCL entities share a common principle of pathogenesis. In support of this concept, we here describe a common deregulation of CD74, which is usually not expressed in T cells, in ALCL. Ligation of CD74 induces cell death of ALCL cells in various conditions, and an anti-CD74-directed antibody-drug conjugate efficiently kills ALCL cell lines. Furthermore, we reveal expression of the proto-oncogene and known CD74 interaction partner MET in a fraction of ALCL cases. These data give insights into ALCL pathogenesis and might help to develop new treatment strategies for ALCL. Abstract In 50–60% of cases, systemic anaplastic large cell lymphoma (ALCL) is characterized by the t(2;5)(p23;q35) or one of its variants, considered to be causative for anaplastic lymphoma kinase (ALK)-positive (ALK+) ALCL. Key pathogenic events in ALK-negative (ALK−) ALCL are less well defined. We have previously shown that deregulation of oncogenic genes surrounding the chromosomal breakpoints on 2p and 5q is a unifying feature of both ALK+ and ALK− ALCL and predisposes for occurrence of t(2;5). Here, we report that the invariant chain of the MHC-II complex CD74 or li, which is encoded on 5q32, can act as signaling molecule, and whose expression in lymphoid cells is usually restricted to B cells, is aberrantly expressed in T cell-derived ALCL. Accordingly, ALCL shows an altered DNA methylation pattern of the CD74 locus compared to benign T cells. Functionally, CD74 ligation induces cell death of ALCL cells. Furthermore, CD74 engagement enhances the cytotoxic effects of conventional chemotherapeutics in ALCL cell lines, as well as the action of the ALK-inhibitor crizotinib in ALK+ ALCL or of CD95 death-receptor signaling in ALK− ALCL. Additionally, a subset of ALCL cases expresses the proto-oncogene MET, which can form signaling complexes together with CD74. Finally, we demonstrate that the CD74-targeting antibody-drug conjugate STRO-001 efficiently and specifically kills CD74-positive ALCL cell lines in vitro. Taken together, these findings enabled us to demonstrate aberrant CD74-expression in ALCL cells, which might serve as tool for the development of new treatment strategies for this lymphoma entity.
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Affiliation(s)
- Kathrin D. Wurster
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Mariantonia Costanza
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Stephan Kreher
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Selina Glaser
- Institute of Human Genetics, Ulm University, Ulm University Medical Center, 89081 Ulm, Germany; (S.G.); (R.S.)
| | - Björn Lamprecht
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
| | - Nikolai Schleussner
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Ioannis Anagnostopoulos
- Institute of Pathology, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany; (I.A.); (K.J.)
| | - Michael Hummel
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
- Institute of Pathology, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany; (I.A.); (K.J.)
| | - Korinna Jöhrens
- Institute of Pathology, Charité–Universitätsmedizin Berlin, 10117 Berlin, Germany; (I.A.); (K.J.)
| | | | - Arturo Molina
- Sutro Biopharma, South San Francisco, CA 94080, USA;
| | - Arjan Diepstra
- Department of Pathology and Medical Biology, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands;
| | - Bernd Gillissen
- Department of Hematology, Oncology, and Tumor Immunology, Charité–Universitätsmedizin Berlin, 13125 Berlin, Germany;
| | - Karl Köchert
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University, Ulm University Medical Center, 89081 Ulm, Germany; (S.G.); (R.S.)
| | - Olaf Merkel
- Unit of Experimental and Laboratory Animal Pathology, Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (O.M.); (L.K.)
- European Research Initiative on ALK-related malignancies (ERIA), 1090 Vienna, Austria
| | - Lukas Kenner
- Unit of Experimental and Laboratory Animal Pathology, Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (O.M.); (L.K.)
- European Research Initiative on ALK-related malignancies (ERIA), 1090 Vienna, Austria
| | - Martin Janz
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
| | - Stephan Mathas
- Max-Delbrück-Center (MDC) for Molecular Medicine, 13125 Berlin, Germany; (M.C.); (N.S.); (M.J.)
- Department of Hematology, Oncology and Cancer Immunology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12200 Berlin, Germany
- Experimental and Clinical Research Center, a joint cooperation between the Charité and the MDC, 13125 Berlin, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;
- European Research Initiative on ALK-related malignancies (ERIA), 1090 Vienna, Austria
- Correspondence: ; Tel.: +49-30-94062863; Fax: +49-30-94063124
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ALK-Negative Anaplastic Large Cell Lymphoma: Current Concepts and Molecular Pathogenesis of a Heterogeneous Group of Large T-Cell Lymphomas. Cancers (Basel) 2021; 13:cancers13184667. [PMID: 34572893 PMCID: PMC8472588 DOI: 10.3390/cancers13184667] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary ALK- anaplastic large cell lymphoma (ALK- ALCL) is a rare subtype of CD30+ large T-cell lymphoma that typically affects older adults and has a poor prognosis. Recognition of its histopathologic spectrum, subtypes, and of other tumors that can resemble ALK- ALCL is crucial to avoid making a wrong diagnosis that could result in inappropriate treatment for a patient. In recent years, several important studies have identified recurrent molecular alterations that have shed light on the pathogenesis of this lymphoma. However, on the other hand, putting all this vast information together into a concise form has become challenging. In this review, we present not only a more detailed view of the histopathologic findings of ALK- ALCL but also, we attempt to provide a more simplified perspective of the relevant genetic and molecular alterations of this type of lymphoma, that in our opinion, is not available to date. Abstract Anaplastic large cell lymphoma (ALCL) is a subtype of CD30+ large T-cell lymphoma (TCL) that comprises ~2% of all adult non-Hodgkin lymphomas. Based on the presence/absence of the rearrangement and expression of anaplastic lymphoma kinase (ALK), ALCL is divided into ALK+ and ALK-, and both differ clinically and prognostically. This review focuses on the historical points, clinical features, histopathology, differential diagnosis, and relevant cytogenetic and molecular alterations of ALK- ALCL and its subtypes: systemic, primary cutaneous (pc-ALCL), and breast implant-associated (BIA-ALCL). Recent studies have identified recurrent genetic alterations in this TCL. In systemic ALK- ALCL, rearrangements in DUSP22 and TP63 are detected in 30% and 8% of cases, respectively, while the remaining cases are negative for these rearrangements. A similar distribution of these rearrangements is seen in pc-ALCL, whereas none have been detected in BIA-ALCL. Additionally, systemic ALK- ALCL—apart from DUSP22-rearranged cases—harbors JAK1 and/or STAT3 mutations that result in the activation of the JAK/STAT signaling pathway. The JAK1/3 and STAT3 mutations have also been identified in BIA-ALCL but not in pc-ALCL. Although the pathogenesis of these alterations is not fully understood, most of them have prognostic value and open the door to the use of potential targeted therapies for this subtype of TCL.
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Hirano Y, Miyawaki S, Tanaka S, Taoka K, Hongo H, Teranishi Y, Takami H, Takayanagi S, Kurokawa M, Saito N. Clinical Features and Prognostic Factors for Primary Anaplastic Large Cell Lymphoma of the Central Nervous System: A Systematic Review. Cancers (Basel) 2021; 13:cancers13174358. [PMID: 34503168 PMCID: PMC8431692 DOI: 10.3390/cancers13174358] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Primary anaplastic large cell lymphoma (ALCL) of the central nervous system (CNS) is a subtype of primary central nervous system lymphoma (PCNSL). ALCL is divided into anaplastic lymphoma kinase (ALK)-positive ALCL and ALK-negative ALCL, according to ALK expression. ALK-positive cancers tend to develop at a younger age and tend to have a better prognosis. Almost all past articles on primary ALCL of the CNS have been case reports and there have been no randomized trials or cohort studies on this subject. We thus performed a systematic review of primary ALCL of the CNS. According to the author’s survey, 36 case reports have been published in English-language journals. In this paper, we have summarized the clinical features and prognostic factors for primary ALCL of the CNS based on previous studies. Abstract Primary anaplastic large cell lymphoma (ALCL) of the central nervous system (CNS) is a subtype of primary CNS lymphoma (PCNSL). There are very few comprehensive reports on this extremely rare tumor. Therefore, it is necessary to investigate the clinical features and prognostic factors for primary ALCL of the CNS. We performed a systematic review of the published literature. Past cases were comprehensively searched using PubMed, Cochrane Library, and Web of Science. Clinical information, such as age, sex, anaplastic lymphoma kinase (ALK) status, lesion sites, treatment methods, and survivorship were extracted. Thirty-nine cases with information on ALK status and treatment course were identified. The average observation period was 13 months, and the overall 2-year survival rate was 58%. Univariate analyses showed a statistically significantly better prognosis among patients < 40 years of age (p = 0.039, HR 0.32 (0.11–0.95)) and in relation to ALK positivity (p = 0.010, HR 0.24 (0.08–0.71) and methotrexate treatment (p = 0.003, HR 0.17 (0.05–0.56)). Because of the sparsity of cases, it is necessary to accumulate cases in order to perform more detailed analyses.
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Affiliation(s)
- Yudai Hirano
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Satoru Miyawaki
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
- Correspondence: ; Tel.: +81-35-800-8853
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Kazuki Taoka
- Department of Hematology and Oncology, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (K.T.); (M.K.)
| | - Hiroki Hongo
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Yu Teranishi
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Shunsaku Takayanagi
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
| | - Mineo Kurokawa
- Department of Hematology and Oncology, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (K.T.); (M.K.)
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; (Y.H.); (S.T.); (H.H.); (Y.T.); (H.T.); (S.T.); (N.S.)
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16
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Wang WJ, Wang J, Ouyang C, Chen C, Xu XF, Ye XQ. Overview of serpin B9 and its roles in cancer (Review). Oncol Rep 2021; 46:190. [PMID: 34278491 DOI: 10.3892/or.2021.8141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022] Open
Abstract
Serine proteinase inhibitor B9 (serpin B9) is a member of the serine protease inhibitor superfamily, which is widely found in animals, plants and microorganisms. Serpin B9 has been reported to protect cells from the immune‑killing effect of granzyme B (GrB) released by lymphocytes. In recent years, an increasing number of studies have indicated that serpin B9 is involved in tumour apoptosis, immune evasion, tumorigenesis, progression, metastasis, drug resistance and even in maintaining the stemness of cancer stem cells (CSCs). Moreover, according to clinical studies, serpin B9 has been demonstrated to be significantly associated with the development of precancerous lesions, a poor prognosis and ineffective therapies, suggesting that serpin B9 may be a potential target for cancer treatment and an indicator of cancer diagnosis; thus, it has begun to attract increased attention from scholars. The present review concisely described the structure and biological functions of the serpin superfamily and serpin B9. In addition, related research on serpins in cancer is discussed in order to provide a comprehensive understanding of the role of serpin B9 in cancer, as well as its clinical significance for cancer diagnosis and prognosis.
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Affiliation(s)
- Wen-Jun Wang
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jiao Wang
- Department of Respiratory Diseases, Jiujiang First People's Hospital, Jiujiang, Jiangxi 332000, P.R. China
| | - Chao Ouyang
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Chong Chen
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xiao-Feng Xu
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xiao-Qun Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Aberrant expression and genetic alteration of c-MYC in anaplastic large cell lymphoma. J Cancer Res Clin Oncol 2021; 148:267-278. [PMID: 34131801 DOI: 10.1007/s00432-021-03691-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE c-MYC plays an important role in regulating cellular growth and apoptosis, and it is aberrantly expressed in many human malignancies. Although c-MYC has been extensively investigated in Burkitt lymphoma and diffuse large B cell lymphoma, little has been reported in anaplastic large cell lymphoma (ALCL). The aim of this study was to investigate the expression and genetic alterations of c-MYC in primary systemic ALCL, characterize its clinicopathologic features and immunophenotypes, and discuss their implications in prognosis. METHODS Tissue microarrays using samples from 85 ALCL patients were used to evaluate expression of c-MYC and anaplastic lymphoma kinase (ALK). c-MYC and ALK genetic alterations were detected using fluorescence in situ hybridization. The Kaplan-Meier and multivariate Cox regression methods were used for survival analysis. RESULTS c-MYC was expressed in 24 of 85 samples (28.2%), and ALK was expressed in 54 (63.5%). c-MYC and ALK were co-expressed in 16 samples (18.8%). c-MYC expression and c-MYC and ALK co-expression increased with ALCL clinical stages and the International Prognostic Index (IPI) score (p < 0.05). Fifty of the samples (58.8%) had ALK rearrangement, and 18 (22.1%) had aneuploidy. c-MYC rearrangement was not detected, but aneuploidy was observed in 19 cases (22.4%). c-MYC aneuploidy was significantly different based on c-MYC expression and the IPI score (p < 0.05). c-MYC was a significant independent prognostic factor for progression-free survival and overall survival in patients with ALCL. CONCLUSION c-MYC protein expression and c-MYC aneuploidy could predict worse survival in patients with ALCL.
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Cortés JR, Palomero T. Biology and Molecular Pathogenesis of Mature T-Cell Lymphomas. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a035402. [PMID: 32513675 DOI: 10.1101/cshperspect.a035402] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Peripheral T-cell lymphomas (PTCLs) constitute a highly heterogeneous group of hematological diseases with complex clinical and molecular features consistent with the diversity of the T-cell type from which they originate. In the past several years, the systematic implementation of high-throughput genomic technologies for the analysis of T-cell malignancies has supported an exponential progress in our understanding of the genetic drivers of oncogenesis and unraveled the molecular complexity of these diseases. Recent findings have helped redefine the classification of T-cell malignancies and provided novel biomarkers to improve diagnosis accuracy and analyze the response to therapy. In addition, multiple novel targeted therapies including small-molecule inhibitors, antibody-based approaches, and immunotherapy have shown promising results in early clinical analysis and have the potential to completely change the way T-cell malignancies have been treated traditionally.
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Affiliation(s)
| | - Teresa Palomero
- Institute for Cancer Genetics.,Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York 10032, USA
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Karki NR, Badin K, Savage N, Bryan L. Leukaemic relapse of anaplastic large cell lymphoma, ALK negative. BMJ Case Rep 2021; 14:14/2/e239213. [PMID: 33619137 PMCID: PMC7903072 DOI: 10.1136/bcr-2020-239213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL), ALK negative (ALK-) is an aggressive lymphoproliferative disorder of mature T lymphocytes characterised by hallmark cells, CD30 positivity and lacking ALK protein expression. ALCL, ALK- has to be differentiated from peripheral T-cell lymphoma-not otherwise specified and classical Hodgkin's lymphoma. ALK- anaplastic large cell leukaemia should be considered in a patient with a history of ALCL, ALK- presenting with new leukaemia. We report a rare presentation of relapsed ALCL, ALK- with leukaemia after autologous stem cell transplantation in a 57-year-old male. Leukaemia, either as primary presentation or secondary transformation confers worse prognosis in ALCL, ALK- with very few cases reported so far. Emergency resuscitation with leukapheresis and treatment of tumour lysis syndrome along with supportive care should be followed by combination chemotherapy. Brentuximab vedotin and stem cell transplantation are the backbone of treatment for relapsed/refractory disease.
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Affiliation(s)
- Nabin Raj Karki
- Hematology Oncology, Augusta University, Augusta, Georgia, USA
| | - Kristine Badin
- Jersey City Medical Center, Jersey City, New Jersey, USA
| | | | - Locke Bryan
- Hematology Oncology, Augusta University, Augusta, Georgia, USA
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The DNA-helicase HELLS drives ALK - ALCL proliferation by the transcriptional control of a cytokinesis-related program. Cell Death Dis 2021; 12:130. [PMID: 33504766 PMCID: PMC7840974 DOI: 10.1038/s41419-021-03425-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022]
Abstract
Deregulation of chromatin modifiers, including DNA helicases, is emerging as one of the mechanisms underlying the transformation of anaplastic lymphoma kinase negative (ALK-) anaplastic large cell lymphoma (ALCL). We recently identified the DNA-helicase HELLS as central for proficient ALK-ALCL proliferation and progression. Here we assessed in detail its function by performing RNA-sequencing profiling coupled with bioinformatic prediction to identify HELLS targets and transcriptional cooperators. We demonstrated that HELLS, together with the transcription factor YY1, contributes to an appropriate cytokinesis via the transcriptional regulation of genes involved in cleavage furrow regulation. Binding target promoters, HELLS primes YY1 recruitment and transcriptional activation of cytoskeleton genes including the small GTPases RhoA and RhoU and their effector kinase Pak2. Single or multiple knockdowns of these genes reveal that RhoA and RhoU mediate HELLS effects on cell proliferation and cell division of ALK-ALCLs. Collectively, our work demonstrates the transcriptional role of HELLS in orchestrating a complex transcriptional program sustaining neoplastic features of ALK-ALCL.
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21
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Stanzani L, Visani E, Chiapparini L, Panzica F, Salmaggi A, Franceschetti S, Canafoglia L. Relevance of neurophysiological assessment in a case of epilepsia partialis continua caused by anaplastic large cell lymphoma. Clin Neurophysiol 2020; 132:165-166. [PMID: 33285380 DOI: 10.1016/j.clinph.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | - Elisa Visani
- Biomedical Engineering, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luisa Chiapparini
- Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ferruccio Panzica
- Clinical Engineering, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | - Laura Canafoglia
- Integrated Diagnostics for Epilepsy, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
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Zhang HF, Guo Y. Acute leukemic phase of anaplastic lymphoma kinase-anaplastic large cell lymphoma: A case report and review of the literature. World J Clin Cases 2020; 8:5439-5445. [PMID: 33269282 PMCID: PMC7674737 DOI: 10.12998/wjcc.v8.i21.5439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/14/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anaplastic large cell lymphoma (ALCL) is a rare and heterogeneous malignant tumor, which is classified as anaplastic lymphoma kinase (ALK)positive ALCL and ALK- ALCL. Many patients are diagnosed with ALCL at the stage of bone marrow involvement. However, ALCL patients with clinical manifestations consistent with acute leukemia are relatively rare.
CASE SUMMARY In this report, the patient did not receive appropriate diagnosis and treatment despite a two-year history of lymph node enlargement. Hereafter, she was admitted for B symptoms and was diagnosed as ALK-ALCL by lymph node biopsy. Then, the disease progressed to leukemia without any treatment after 2 mo. The proportion of lymphoma cells in bone marrow was as high as 96%, and the proportion of peripheral blood was 84%. She also had clinical manifestations similar to acute leukemia. After completion of chemotherapy, she developed granulocytopenia and fever and died from septicemia.
CONCLUSION ALCL with leukemic presentation is a late manifestation of lymphoma with low chemotherapy tolerance and poor prognosis.
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Affiliation(s)
- Huai-Feng Zhang
- Department of Hematology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Yan Guo
- Department of Hematology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
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23
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Thomas L, Cousen P, Svec A, Robinson K, Carmichael AJ. Treatment-resistant presumed allergic contact dermatitis of the face. Clin Exp Dermatol 2020; 46:391-393. [PMID: 33091185 DOI: 10.1111/ced.14472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/17/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- L Thomas
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - P Cousen
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - A Svec
- Department of Histopathology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - K Robinson
- Department of Haematology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
| | - A J Carmichael
- Departments of, Department of Dermatology, The James Cook University Hospital, Middlesbrough, North Yorkshire, UK
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Aggressive Disease Course of Multiple Myeloma with Concomitant ALK-Negative Anaplastic Large Cell Lymphoma: A Case Report with an Unusual Presentation. Case Rep Hematol 2020; 2020:6309736. [PMID: 32509362 PMCID: PMC7201522 DOI: 10.1155/2020/6309736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 12/09/2019] [Accepted: 12/28/2019] [Indexed: 11/29/2022] Open
Abstract
ALK-negative anaplastic large cell lymphoma is a rare T-cell neoplasm with an aggressive course requiring prompt diagnostic work-up and treatment. Few cases of concomitant multiple myeloma and T-cell neoplasm are described in the literature, mainly regarding primary cutaneous anaplastic large cell lymphoma. We present the case of a 65-year-old man, simultaneously diagnosed with ALK-negative anaplastic large cell lymphoma with extranodal localization in the gastrocnemius muscle (stage 1AE) and IgG lambda multiple myeloma (ISS 2, Durie-Salmon stage 3A). Both diseases required therapeutic intervention due to the high proliferative index of lymphoma and the presence of bone lesions attributable to myeloma. The therapeutic program initially included chemotherapy (cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; CHOEP), radiotherapy on the leg, bortezomib, and then consolidation with autologous hematopoietic stem cell transplantation. Despite being on bortezomib treatment and waiting for transplantation, the patient experienced an early myeloma progression that turned out to be refractory to second-line lenalidomide-based treatment. To our knowledge, this is the first case of concurrent diagnosis of extranodal ALK-negative anaplastic large cell lymphoma of the muscle and multiple myeloma. Simultaneous onset can be challenging for clinicians as both diseases may have an aggressive course requiring multiple treatments with increased risk of toxicity and complicated management.
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Yamashita Y, Hori Y, Kosako H, Oiwa T, Warigaya K, Mushino T, Murata S, Fujimoto M, Nishikawa A, Murata SI, Sonoki T, Tamura S. Brentuximab vedotin for refractory anaplastic lymphoma kinase-negative anaplastic large cell lymphoma in leukemic phase with RUNX3 overexpression. Hematol Rep 2020; 12:8368. [PMID: 32499905 PMCID: PMC7256628 DOI: 10.4081/hr.2020.8368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 01/07/2020] [Indexed: 01/07/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)- negative anaplastic large cell lymphoma (ALCL) is an aggressive CD30-positive non- Hodgkin lymphoma. ALK-ALCL rarely manifests with extensive bone marrow and peripheral blood involvement (known as “leukemic phase”). A 54-year-old woman was diagnosed with ALK-ALCL in leukemic phase, characterized by an extremely poor prognosis. Lymphoma cells in this case showed chromosomal translocation 1p36.1- encoded RUNX3 and overexpression of its protein. She was refractory to CHOP and salvage chemotherapy. Fortunately, she achieved complete remission with three cycles of Brentuximab vedotin (BV) and underwent umbilical cord blood transplantation. However, she died due to treatment-related mortality on day 129. The autopsy findings showed no lymphoma cells. Treatment strategy for ALK-ALCL is controversial, but the efficacy of BV in CD30-positive peripheral T-cell lymphoma not only as salvage regimens, but also in first line, has been reported in recent years. BV may be an effective option for ALK-ALCL in leukemic phase.
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Affiliation(s)
| | | | | | | | - Kenji Warigaya
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
| | | | | | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
| | | | - Shin-Ichi Murata
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
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St Cyr TL, Pockaj BA, Northfelt DW, Craig FE, Clemens MW, Mahabir RC. Breast Implant-Associated Anaplastic Large-Cell Lymphoma: Current Understanding and Recommendations for Management. Plast Surg (Oakv) 2020; 28:117-126. [PMID: 32596187 PMCID: PMC7298574 DOI: 10.1177/2292550320925906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Worldwide, millions of women live with breast implants. Therefore, it is important that physicians be aware of an uncommon but possibly serious complication arising from breast implants: breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Breast implant-associated anaplastic large-cell lymphoma most commonly presents as a delayed fluid collection around a textured breast implant or as a mass in the capsule surrounding the implant. The exact pathogenesis of the disease remains unclear. The neoplastic cells of BIA-ALCL show strong uniform staining for CD30 and are consistently negative for activin receptor-like kinase 1. Patients with confirmed cases should be referred to a lymphoma specialist or breast medical oncologist for a complete oncologic evaluation before any surgical intervention. For disease confined to the fluid accumulation or capsule, or both, surgical removal of the implant and complete capsulectomy is the preferred treatment. Postoperative chemotherapy or radiation, or both, are not considered necessary for patients with limited-stage disease and are reserved for advanced disease stages. Generally, BIA-ALCL is a local disease that follows an indolent course and has an excellent prognosis. Although complete remission of disease has occurred in patients with BIA-ALCL, median overall survival is reduced. As of March 2018, approximately 529 unique, confirmed BIA-ALCL cases had been reported in 23 countries. To date, 16 patients have died from BIA-ALCL, and all had extracapsular involvement. The aim of this article is to summarize the diagnosis, evaluation, and management of BIA-ALCL, based on established guidelines, for all practitioners who may care for patients with breast implants.
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Affiliation(s)
- Tessa L St Cyr
- Mayo Clinic School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Barbara A Pockaj
- Division of General Surgery, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Donald W Northfelt
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Fiona E Craig
- Division of Hematopathology, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Mark W Clemens
- Department of Plastic Surgery, Division of Surgery, MD Anderson Cancer Center, Houston, TX, USA
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Gru AA, McHargue C, Salavaggione AL. A Systematic Approach to the Cutaneous Lymphoid Infiltrates: A Clinical, Morphologic, and Immunophenotypic Evaluation. Arch Pathol Lab Med 2020; 143:958-979. [PMID: 31339758 DOI: 10.5858/arpa.2018-0294-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The evaluation of cutaneous lymphoid infiltrates, both neoplastic and inflammatory, occurs very frequently in routine dermatopathologic examination and consultation practices. The "tough" cutaneous lymphoid infiltrate is feared by many pathologists; skin biopsies are relatively small, whereas diagnostic possibilities are relatively broad. It is true that cutaneous lymphomas can be difficult to diagnose and that in many circumstances multiple biopsies are required to establish a correct diagnostic interpretation. As a reminder, one should understand that low-grade cutaneous lymphomas are indolent disorders that usually linger for decades and that therapy does not result in disease cure. It is also important to remember that in most circumstances, those patients will die from another process that is completely unrelated to a diagnosis of skin lymphoma (even in the absence of specific therapy). OBJECTIVE.— To use a clinicopathologic, immunophenotypic, and molecular approach in the evaluation of common lymphocytic infiltrates. DATA SOURCES.— An in-depth analysis of updated literature in the field of cutaneous lymphomas was done, with particular emphasis on updated terminology from the most recent World Health Organization classification of skin and hematologic tumors. CONCLUSIONS.— A diagnosis of cutaneous lymphoid infiltrates can be adequately approached using a systematic scheme following the proposed ABCDE system. Overall, cutaneous T- and B-cell lymphomas are rare and "reactive" infiltrates are more common. Evaluation of lymphoid proliferations should start with a good sense of knowledge of the clinical presentation of the lesions, the clinical differential considerations, and a conscientious and appropriate use of immunohistochemistry and molecular tools.
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Affiliation(s)
- Alejandro A Gru
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
| | - Chauncey McHargue
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
| | - Andrea L Salavaggione
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
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Karube K, Nakada N, Yamamoto H. Primary bone anaplastic large cell lymphoma of lymphohistiocytic variant, ALK-negative: A challenging diagnosis. Pathol Int 2020; 70:376-378. [PMID: 32243017 DOI: 10.1111/pin.12928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/06/2020] [Accepted: 03/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Kennosuke Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | | | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
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Fragliasso V, Verma A, Manzotti G, Tameni A, Bareja R, Heavican TB, Iqbal J, Wang R, Fiore D, Mularoni V, Chan WC, Lhoumaud P, Skok J, Zanetti E, Merli F, Ciarrocchi A, Elemento O, Inghirami G. The novel lncRNA BlackMamba controls the neoplastic phenotype of ALK - anaplastic large cell lymphoma by regulating the DNA helicase HELLS. Leukemia 2020; 34:2964-2980. [PMID: 32123306 DOI: 10.1038/s41375-020-0754-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 01/09/2023]
Abstract
The molecular mechanisms leading to the transformation of anaplastic lymphoma kinase negative (ALK-) anaplastic large cell lymphoma (ALCL) have been only in part elucidated. To identify new culprits which promote and drive ALCL, we performed a total transcriptome sequencing and discovered 1208 previously unknown intergenic long noncoding RNAs (lncRNAs), including 18 lncRNAs preferentially expressed in ALCL. We selected an unknown lncRNA, BlackMamba, with an ALK- ALCL preferential expression, for molecular and functional studies. BlackMamba is a chromatin-associated lncRNA regulated by STAT3 via a canonical transcriptional signaling pathway. Knockdown experiments demonstrated that BlackMamba contributes to the pathogenesis of ALCL regulating cell growth and cell morphology. Mechanistically, BlackMamba interacts with the DNA helicase HELLS controlling its recruitment to the promoter regions of cell-architecture-related genes, fostering their expression. Collectively, these findings provide evidence of a previously unknown tumorigenic role of STAT3 via a lncRNA-DNA helicase axis and reveal an undiscovered role for lncRNA in the maintenance of the neoplastic phenotype of ALK-ALCL.
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Affiliation(s)
- Valentina Fragliasso
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Akanksha Verma
- Institute for Computational Biomedicine & Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA.,Tri-Institutional Training Program in Computational Biology and Medicine, New York, NY, 10065, USA
| | - Gloria Manzotti
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Annalisa Tameni
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, 41125, Italy
| | - Rohan Bareja
- Institute for Computational Biomedicine & Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Tayla B Heavican
- Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68182, USA
| | - Javeed Iqbal
- Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68182, USA
| | - Rui Wang
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Danilo Fiore
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Valentina Mularoni
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Priscillia Lhoumaud
- Department of Pathology, New York University School of Medicine, Langone Medical Center, New York, NY, 10016, USA
| | - Jane Skok
- Department of Pathology, New York University School of Medicine, Langone Medical Center, New York, NY, 10016, USA
| | - Eleonora Zanetti
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy.
| | - Oliver Elemento
- Institute for Computational Biomedicine & Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA.
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, 10065, USA.
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Fratoni S, Niscola P, Zhao XF, Larocca LM, Capalbo A, Fabbretti M, Bernardini L, Abruzzese E. ALK-negative anaplastic large cell lymphoma with “Hodgkin-like” cytomorphology and nuclear expression of PAX5. Pathol Res Pract 2020; 216:152724. [DOI: 10.1016/j.prp.2019.152724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/12/2019] [Accepted: 10/26/2019] [Indexed: 10/25/2022]
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Kasinathan G. Leukemic phase of ALK-negative anaplastic large cell lymphoma in a patient who is on androgenic steroids: A case report. Ann Med Surg (Lond) 2019; 49:1-4. [PMID: 31871676 PMCID: PMC6909107 DOI: 10.1016/j.amsu.2019.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 12/27/2022] Open
Abstract
ALK-negative anaplastic large cell lymphoma (ALCL) is a peripheral T-cell lymphoma that usually involves lymph nodes or extranodal sites. Leukemic phase of ALK-negative ALCL is exceedingly rare and often carries a poor prognosis. Androgenic steroids have gained popularity among the young, and at higher doses, it can result in immune dysregulation and may be potentially carcinogenic. Case presentation: A 30-year-old gentleman of Malay ethnicity presented to the hematology department with night fevers, loss of weight and bony pain for the past 6 weeks. He is a gymnasium instructor with a history of chronic usage of intramuscular testosterone enanthate. Physical examination revealed ecchymosis over the left elbow and hepatomegaly. A complete blood count depicted anemia, thrombocytopenia and leucocytosis. An 18-Fluorodeoxyglucose positron emission tomography (18-FDG PET/CT) imaging showed a hypermetabolic anterior mediastinal mass of 6.8 × 7.0 × 6.5 cm with diffuse hypermetabolism in the liver, spleen and axial skeleton. The bone marrow trephine and mediastinal tissue histology were consistent with leukemic ALK-negative ALCL. He was treated with CHOEP (cyclophosphamide, doxorubicin, vincristine, etoposide, prednisolone) induction chemotherapy in which he required intensive antibiotic and blood support. He progressed with worsening B symptoms and new diffuse lymphadenopathies suggesting rapid dissemination of the disease. He subsequently succumbed to multiorgan failure with disseminated intravascular coagulopathy at the intensive care unit. Conclusion: Leukemic phase ALK-negative ALCL often carries a complex karyotype and requires early intensive polychemotherapy. Use of anabolic steroids depletes the ability of defending lymphocytes to remove tumour producing cells. Clinicopathological correlation is imperative in the diagnosis of leukemic phase ALK-negative anaplastic large cell lymphoma. Leukemic phase ALK-negative anaplastic large cell lymphoma progresses rapidly if the diagnosis is delayed. Anabolic steroids compromises the immune system and depletes the ability of lymphocytes to remove tumour producing cells.
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Affiliation(s)
- Ganesh Kasinathan
- Department of Hematology, Jalan Mewah Utara, Pandan Mewah, 68000, Ampang, Selangor, Malaysia
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Abstract
Anaplastic large cell lymphomas are a rare subtype of peripheral/mature T-cell lymphomas which are clinically, pathologically and genetically heterogeneous. Both ALK-positive (ALK+) and ALK-negative (ALK-) ALCL are composed of large lymphoid cells with abundant cytoplasm and pleomorphic features with horseshoe-shaped and reniform nuclei. ALK+ ALCL were considered as a definite entity in the 2008 World Health Organization classification of hematopoietic and lymphoid tissues. ALK-ALCL was included as a provisional entity in the WHO 2008 edition and in the most recent 2017 edition, it is now considered a distinct entity that includes cytogenetic subsets that appear to have prognostic implications (e.g. 6p25 rearrangements at IRF4/DUSP22 locus). ALK+ ALCLs are distinct in epidemiology and pathogenetic origin and should be distinguished from ALK-ALCL, cutaneous ALCL and breast implant associated ALCL which have distinct clinical course and pathogenetic features. Breast implant-associated ALCL is now recognized as a new provisional entity distinct from other ALK-ALCL; notably that it is a noninvasive disease associated with excellent outcome. In this article, we will provide an overview of the salient themes relevant to the pathology and genetic mechanisms in ALCL.
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Affiliation(s)
- Vasiliki Leventaki
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Siddharth Bhattacharyya
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States
| | - Megan S Lim
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States.
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Ismail S, Haydar M, Ghanem A, Alkadi S, Al-Shehabi Z. Pediatric mediastinal ALK- negative anaplastic large cell lymphoma (Hodgkin-like pattern) in a 13-year-old girl: a case report and review of literature. Oxf Med Case Reports 2019; 2019:omz077. [PMID: 31772744 PMCID: PMC6735755 DOI: 10.1093/omcr/omz077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/08/2019] [Accepted: 07/07/2019] [Indexed: 11/14/2022] Open
Abstract
Anaplastic large-cell Lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma that is characterized by an entity of large neoplastic cells labeled by the Ki-1 antibody. It constitutes ~2% of all lymphoid neoplasms and is divided into two main categories: anaplastic large-cell kinase (ALK)+ALCL and ALK-ALCL that is recognized by the absence of ALK expression and mostly affects men at older ages. Thus, in this report we present a rare case of ALK-negative ALCL (ALK-ALCL) that was described and diagnosed in a 13-year-old girl in the mediastinum. Highlighting the rarity of manifestation at younger ages and the importance of using immunohistochemical staining in the differential diagnosis of this lymphoid neoplasm.
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Affiliation(s)
- Sawsan Ismail
- Department of Pathology, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Mariana Haydar
- Department of Pediatrics, Pediatrics and Obstetrics Hospital, Lattakia, Syria
| | - Abdulmoniem Ghanem
- Department of Pediatrics, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Sulman Alkadi
- Department of Thoracic Surgery, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Zuheir Al-Shehabi
- Department of Pathology, Faculty of Medicine, Tishreen University, Lattakia, Syria
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Luo J, Jiang YH, Lei Z, Miao YL. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma masquerading as Behcet's disease: A case report and review of literature. World J Clin Cases 2019; 7:3377-3383. [PMID: 31667195 PMCID: PMC6819288 DOI: 10.12998/wjcc.v7.i20.3377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/24/2019] [Accepted: 09/11/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anaplastic large cell lymphoma (ALCL) is a CD30-positive T cell lymphoma, a rare type of non-Hodgkin lymphoma. The current World Health Organization classification system divides ALCLs into anaplastic lymphoma kinase (ALK)-positive and ALK-negative groups. ALCL rarely presents in the gastrointestinal tract.
CASE SUMMARY A 54-year-old male was admitted to the department of gastroenterology for abdominal pain. He presented with lower abdominal pain, diarrhea and recurrent oral and penile ulcers. He was misdiagnosed with Behcet's disease and treated with prednisone. But after one month, he was hospitalized in another hospital for reexamination. This time, the lesion on the penis was biopsied for histological examination. The final pathological diagnosis was ALCL, ALK-negative. The patient was treated with cyclophosphamide, doxorubicin, vincristine, prednisolone chemotherapy. However, he died within one month.
CONCLUSION Gastrointestinal ALCL needs to be considered in the differential diagnosis to avoid delaying treatment. Repeated biopsy is the most important for early diagnosis and treatment.
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Affiliation(s)
- Juan Luo
- Department of Gastroenterology, the First Affiliated Hospital of Kunming Medical University, Institute of Digestive Disease, Kunming 650000, Yunnan Province, China
| | - Ying-Han Jiang
- Department of Pathology, the First People’s Hospital of Yunnan Province, Kunming 650000, Yunnan Province, China
| | - Zi Lei
- Department of Pathology, the First Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan Province, China
| | - Ying-Lei Miao
- Department of Gastroenterology, the First Affiliated Hospital of Kunming Medical University, Institute of Digestive Disease, Kunming 650000, Yunnan Province, China
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Nanni L, Pellegrini C, Stefoni V, Argnani L, Cavo M, Zinzani PL. Successful Employment of Brentuximab Vedotin in a Patient Undergoing Hemodialysis: The First Real-life Experience. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:e595-e596. [PMID: 31543370 DOI: 10.1016/j.clml.2019.07.443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/26/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Nanni
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Cinzia Pellegrini
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Vittorio Stefoni
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Lisa Argnani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Michele Cavo
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
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Wang X, Wu J, Zhang M. Advances in the treatment and prognosis of anaplastic lymphoma kinase negative anaplastic large cell lymphoma. ACTA ACUST UNITED AC 2019; 24:440-445. [PMID: 31072226 DOI: 10.1080/16078454.2019.1613290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anaplastic lymphoma kinase negative anaplastic large cell lymphoma (ALK- ALCL) is a definite entity in the WHO 2016 Classification that represents 2-3% of non-Hodgkin lymphoma (NHL) and 12% of T-cell NHL cases. ALK- ALCL lacks ALK protein expression, but expresses CD30 and has morphologic features similar to ALK positive anaplastic large cell lymphoma (ALK+ ALCL). Some studies indicate that ALK- ALCL and ALK+ ALCL possess different molecular and genetic characteristics. Besides, ALK- ALCL is worse than ALK+ ALCL in terms of treatment outcome, prognosis, and long-term survival. This review is aimed at summarizing information about ALK- ALCL, especially with respect to the treatment and prognosis.
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Affiliation(s)
- Xiaoli Wang
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
| | - Jingjing Wu
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
| | - Mingzhi Zhang
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
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Kakkar A, Sharma B, Das P, Jain S, Dattagupta S, Sood R. ALK-Negative Anaplastic Large-Cell Lymphoma Diagnosed on Liver Biopsy in a Child Presenting with Nonresolving Pyrexia. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_153_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractALK-negative anaplastic large-cell lymphoma (ALCL) is a rare non-Hodgkin lymphoma occurring in adulthood. We report a case of a 13-year-old boy who presented with a 6-month history of fever with jaundice and pancytopenia. Computed tomography abdomen showed multiple hypodense lesions in the liver. Bone marrow biopsy revealed necrotizing granulomas. The patient was treated with antitubercular treatment but failed to show a response. Liver biopsy performed subsequently showed features of ALK-negative ALCL. Extranodal involvement in ALK-negative ALCL can have unusual clinical presentations. This case highlights the utility of timely tissue diagnosis in patients with nonresolving pyrexia and organ lesions on imaging.
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Affiliation(s)
- Aanchal Kakkar
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Bhavna Sharma
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Jain
- Departments of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Dattagupta
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rita Sood
- Departments of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
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Dang Q, Chen L, Xu M, You X, Zhou H, Zhang Y, Shi W. The γ-secretase inhibitor GSI-I interacts synergistically with the proteasome inhibitor bortezomib to induce ALK+ anaplastic large cell lymphoma cell apoptosis. Cell Signal 2019; 59:76-84. [PMID: 30878517 DOI: 10.1016/j.cellsig.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/21/2022]
Abstract
Single agent treatment of the γ-secretase inhibitor (GSI-I) or proteasome inhibitor in anaplastic lymphoma kinase positive anaplastic large cell lymphoma (ALK+ ALCL) shows limited response and considerable toxicity. Here, we examined the effects of the combination of low dose GSI-I and the proteasome inhibitor bortezomib (BTZ) in ALK+ ALCL cells in vivo and in vitro. We found that ALK+ ALCL cells treated with the BTZ and GSI-I combination treatment showed elevated apoptosis, consistent with increased caspase activation, compared with BTZ or GSI-I alone. The combination treatment also inhibited AKT and extracellular signal-related kinase pathways, as well as stress-related cascades, including the c-jun N-terminal kinase and stress-activated kinases. Moreover, combined treatment in a murine xenograft model resulted in increased apoptosis in tumor tissues and reduced tumor growth. Our results reveal the synergistic anti-tumor effects of low dose inhibitors against γ-secretase and the proteasome and suggest the potential application of the tolerable BTZ/GSI-I combined agents in treating ALK+ ALCL in future clinical treatment.
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Affiliation(s)
- Qingxiu Dang
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Lili Chen
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Mengqi Xu
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Xuefen You
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Hong Zhou
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China
| | - Yaping Zhang
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China.
| | - Wenyu Shi
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China.
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Stack A, Levy I. Brentuximab vedotin as monotherapy for unresectable breast implant-associated anaplastic large cell lymphoma. Clin Case Rep 2019; 7:1003-1006. [PMID: 31110735 PMCID: PMC6510013 DOI: 10.1002/ccr3.2142] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/21/2019] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
BI-ALCL is a rare CD30+ T-cell malignancy, which is known to complicate textured breast implants. The CD30-targeting immunoconjugate, brentuximab vedotin, has been suggested for invasive BI-ALCL; however, its efficacy for unresectable BI-ALCL has not been demonstrated. We present a case of unresectable BI-ALCL, which was successfully treated with brentuximab vedotin.
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Affiliation(s)
- Anthony Stack
- Department of Internal MedicineTemple University HospitalPhiladelphiaPennsylvania
| | - Isaac Levy
- Millennium OncologyPembroke PinesFlorida
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Lim Y, Park JH, Lee DY. Prognostic Value of Leukocytosis in Systemic Anaplastic Large-Cell Lymphoma with Cutaneous Involvement. Ann Dermatol 2018; 30:721-724. [PMID: 33911515 PMCID: PMC7992460 DOI: 10.5021/ad.2018.30.6.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/30/2017] [Accepted: 12/11/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Youngkyoung Lim
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Youn Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kawamoto K, Suzuki T, Kasami T, Kiryu M, Sone H, Miyoshi H, Ohshima K, Takizawa J. Safety and effective salvage regimen comprising a novel combination of brentuximab vedotin, L-asparaginase, and dexamethasone for refractory anaplastic large cell lymphoma, anaplastic lymphoma kinase negative. Hematol Oncol 2018; 37:212-214. [PMID: 30394560 DOI: 10.1002/hon.2565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Keisuke Kawamoto
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Takaharu Suzuki
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Takuya Kasami
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Maiko Kiryu
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
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Pernot B, Gyan E, Maillot F, Hodges P, Ertault M, Ferreira-Maldent N. Lymphomas diagnosed in an internal medicine department compared to lymphomas diagnosed in other departments: Clinical and outcome differences. Medicine (Baltimore) 2018; 97:e13228. [PMID: 30461623 PMCID: PMC6392786 DOI: 10.1097/md.0000000000013228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lymphomas are common malignancies with highly variable clinical presentations and prognosis. Prognostic value of clinical presentation at onset is still questioned. The objective of this study was to compare the disease presentation and the outcome of lymphomas diagnosed in an Internal Medicine Department of a University Hospital to disease presentation and outcome of patients who were referred to the Hematology Department of the same institution by other departments or healthcare facilities.This retrospective monocentric observational study included 37 patients. They were matched to 73 patients, who were referred to the Hematology Department, according to age, histology, and Ann Arbor stage. The demographics, clinical and biological presentations, overall survival, and progression-free survival were compared.Patients diagnosed with lymphoma in the Internal Medicine Department were more likely to be febrile (67.5% vs 21.9%; P < .001) and have higher inflammatory markers (mean C-reactive protein 86.6 vs 56.3 mg/L; P = .02). The median overall survival of these patients was poorer (P < .001), even in the subset of patients treated with standard treatment, and remained shorter in multivariable analysis (P = .002). The specific treatment started earlier (20.2 vs 37.5 days; P = .006), but was more frequently palliative (37.8% vs 19.2%; P = .04). There was no significant difference in median progression-free survival.Lymphomas diagnosed in an Internal Medicine Department had aggressive clinical presentations and a poorer outcome, despite an early start of conventional treatment.
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Affiliation(s)
- Benoit Pernot
- Geriatrics Department, Hospital Center André Gibotteau, Boulevard Kennedy, Vendôme
| | - Emmanuel Gyan
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - François Maillot
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Penelope Hodges
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Marjan Ertault
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - Nicole Ferreira-Maldent
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
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Lapthanasupkul P, Songkampol K, Boonsiriseth K, Kitkumthorn N. Anaplastic large cell lymphoma of the palate: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 120:172-175. [PMID: 30291889 DOI: 10.1016/j.jormas.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/27/2018] [Accepted: 09/26/2018] [Indexed: 01/31/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a very rare subtype of T-cell non-Hodgkin's lymphoma (NHL). Similar to other types of NHL, ALCL primarily involves the nodal areas and sometimes it can involve several extranodal sites such as skin, lung and soft tissue. Primary oral involvement of systemic ALCL is very rare. We report a 55-year-old Thai female with anaplastic lymphoma kinase (ALK)-negative ALCL primarily occurring at the hard palate. The patient was referred to the Department of Oral and Maxillofacial Surgery, Mahidol University, complaining of a swelling on her left palate. An incisional biopsy was performed and revealed a diffuse infiltration of large pleomorphic cells with prominent nuclei and sometimes eccentric horseshoe-shaped nuclei. The tumor cells showed a positivity for CD30, CD2, CD4, CD43 and EMA. A few tumor cells were positive to CD45 and CD3. They were negative for CD5, CD8, CD20, AE1/AE3, HMB45, ALK, TCRαβ, TCRγδ, and EBER. The patient reported a decrease in lesionsize after two courses of chemotherapy. However, approximately six months after beginning chemotherapy the tumor metastasized to the nasal cavities and brain. This case represented another rare systemic ALK-negative ALCL case primarily involving the oral cavity.
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Affiliation(s)
- P Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, 6, Yothi street, 10400 Bangkok, Thailand.
| | - K Songkampol
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - K Boonsiriseth
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - N Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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44
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Donato EM, Fernández-Zarzoso M, Hueso JA, de la Rubia J. Brentuximab vedotin in Hodgkin lymphoma and anaplastic large-cell lymphoma: an evidence-based review. Onco Targets Ther 2018; 11:4583-4590. [PMID: 30122950 PMCID: PMC6084082 DOI: 10.2147/ott.s141053] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hodgkin lymphoma (HL) and anaplastic large-cell lymphoma (ALCL) account for ~10% and 2%-3% of all cases of lymphoid neoplasms, respectively. Up to 30% of patients with HL are refractory or relapse after first-line therapy, and elderly patients with HL represent a subgroup of patients with suboptimal responses to the currently available treatments. Five-year overall survival for ALCL patients is 50%-80% with conventional chemotherapy. Therefore, new therapeutic approaches are needed for these groups of patients. Brentuximab vedotin is a chimeric IgG1 anti-CD30 antibody-drug conjugate that has all the features that are necessary to make a substantive difference with the standard therapies in patients with HL and ALCL: a novel mechanism of action, single-agent activity, non-cross-resistance, and safety both in the relapsed-refractory and in the front-line setting. This review provides an update of the results of the most relevant clinical trials including brentuximab vedotin for patients with HL and ALCL conducted to date.
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Affiliation(s)
- Eva M Donato
- Hematology Service, University Hospital Doctor Peset, Valencia, Spain,
| | | | | | - Javier de la Rubia
- Hematology Service, University Hospital Doctor Peset, Valencia, Spain,
- Department of Internal Medicine, Universidad Católica de Valencia "San Vicente Mártir," Valencia, Spain
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45
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Bhattacharjee R, Vinay K, Chatterjee D, Malhotra P, Dogra S. Comments concerning "ALK positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature". Int J Dermatol 2018; 57:e83-e85. [PMID: 30047595 DOI: 10.1111/ijd.14156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 06/23/2018] [Accepted: 07/04/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Rajsmita Bhattacharjee
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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46
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Kotidis E, Ioannidis O, Pramateftakis MG, Christou K, Kanellos I, Tsalis K. Atypical anastomotic malignancies of small bowel after subtotal gastrectomy with Billorth II gastroenterostomy for peptic ulcer: Report of three cases and review of the literature. World J Gastrointest Oncol 2018; 10:194-201. [PMID: 30079145 PMCID: PMC6068855 DOI: 10.4251/wjgo.v10.i7.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/25/2018] [Accepted: 06/09/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To present patients who developed small-bowel malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy for ulcer, to review relevant literature, and to attempt to interpret the reasons those cancers developed to these postsurgical non-gastric sights.
METHODS For the current retrospective study and review of literature, the surgical and histopathological records dated from January 1, 1993 to December 31, 2017 of our department were examined, searching for patients who have undergone surgical treatment of small-bowel malignancy to identify those who have undergone subtotal gastrectomy for benign peptic ulcer. A systematic literature search was also conducted using PubMed, EMBASE, and Cochrane Library to identify similar cases.
RESULTS We identified three patients who had developed small-intestine malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy with Billroth II gastroenterostomy for benign peptic ulcer-two patients with adenocarcinoma originated in the Braun anastomosis and one patient with lymphoma of the efferent loop. All three patients were submitted to surgical resection of the tumor with Roux-en-Y reconstruction of the digestive tract. In the literature review, we only found one case of primary small-intestinal cancer that originated in the efferent loop after Billroth II gastrectomy because of duodenal ulcer but none reporting Braun anastomosis adenocarcinoma following partial gastrectomy for benign disease. We also did not find any case of efferent loop lymphoma following gastrectomy.
CONCLUSION Anastomotic gastric cancer following distal gastrectomy for peptic ulcer is a well-established clinical entity. However, malignancies of the afferent or efferent loop of the gastrointestinal anastomosis are extremely uncommon. The substantial diversion of the potent carcinogenic pancreaticobiliary secretions through the Braun anastomosis and the stomach hypochlorhydria, allowing the formation of carcinogenic factors from food, are the two most prominent pathogenetic mechanisms for those tumors.
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Affiliation(s)
- Efstathios Kotidis
- Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Orestis Ioannidis
- Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | | | - Konstantinos Christou
- Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Ioannis Kanellos
- Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
| | - Konstantinos Tsalis
- Fourth Surgical Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
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Loghavi S, Medeiros LJ, Javadi S, Lin P, Khoury JD, Nastoupil L, Hunt KK, Clemens MW, Miranda RN. Breast Implant-Associated Anaplastic Large Cell Lymphoma With Bone Marrow Involvement. Aesthet Surg J 2018; 38:4964709. [PMID: 29635424 DOI: 10.1093/asj/sjy097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
LEVEL OF EVIDENCE 5
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Affiliation(s)
- Sanam Loghavi
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Jeffrey Medeiros
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sanaz Javadi
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Pei Lin
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Joseph D Khoury
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Loretta Nastoupil
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kelly K Hunt
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mark W Clemens
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Roberto N Miranda
- Departments of Hematopathology, Diagnostic Radiology, Lymphoma/Myeloma, Breast Surgical Oncology, and Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
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48
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Huang PS, Chung IH, Lin YH, Lin TK, Chen WJ, Lin KH. The Long Non-Coding RNA MIR503HG Enhances Proliferation of Human ALK-Negative Anaplastic Large-Cell Lymphoma. Int J Mol Sci 2018; 19:ijms19051463. [PMID: 29758012 PMCID: PMC5983830 DOI: 10.3390/ijms19051463] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/10/2018] [Accepted: 05/12/2018] [Indexed: 02/07/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL) is a rare type of highly malignant, non-Hodgkin lymphoma. Currently, only a few gene rearrangements have been linked to ALK-negative ALCL progression. However, the specific molecular mechanisms underlying the growth of ALK-negative ALCL tumors remain unclear. Here, we investigated aberrantly expressed, long non-coding RNAs (lncRNAs) in ALK-negative ALCL and assessed their potential biological function. MIR503HG (miR-503 host gene) was highly expressed in ALK-negative cell lines and was significantly upregulated in tumors in mice formed from ALK-negative ALCL cell lines. Depletion of MIR503HG suppressed tumor cell proliferation in vivo and in vitro; conversely, its overexpression enhanced tumor cell growth. MIR503HG-induced proliferation was mediated by the induction of microRNA-503 (miR-503) and suppression of Smurf2, resulting in stabilization of the tumor growth factor-β receptor (TGFBR) and enhanced tumor cell growth. Collectively, these findings support a potential role for MIR503HG in cancer cell proliferation through the miR-503/Smurf2/TGFBR axis and indicate that MIR503HG is a potential marker in ALK-negative ALCL.
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MESH Headings
- Anaplastic Lymphoma Kinase
- Animals
- Cell Line, Tumor
- Cell Proliferation
- Disease Models, Animal
- Gene Expression Regulation, Neoplastic
- Heterografts
- Humans
- Lymphoma, Large-Cell, Anaplastic/genetics
- Lymphoma, Large-Cell, Anaplastic/metabolism
- Lymphoma, Large-Cell, Anaplastic/pathology
- Mice
- MicroRNAs/genetics
- RNA Interference
- RNA, Long Noncoding/genetics
- Receptor Protein-Tyrosine Kinases/deficiency
- Receptors, Transforming Growth Factor beta
- Ubiquitin-Protein Ligases/genetics
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Affiliation(s)
- Po-Shuan Huang
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| | - I-Hsiao Chung
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| | - Yang-Hsiang Lin
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan.
| | - Tzu-Kang Lin
- Neurosurgery, Fu Jen Catholic University Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City 24250, Taiwan.
| | - Wei-Jan Chen
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
| | - Kwang-Huei Lin
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan.
- Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan.
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Zhang W, Burton S, Wu S, Qian X, Rajeh MN, Schroeder K, Shuldberg M, Merando A, Lai JP. Primary Gastric ALK-negative EBV-negative Anaplastic Large Cell Lymphoma Presenting with Iron Deficiency Anemia. ACTA ACUST UNITED AC 2018; 31:701-704. [PMID: 28652442 DOI: 10.21873/invivo.11116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/09/2017] [Accepted: 04/10/2017] [Indexed: 02/08/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare subtype of non-Hodgkin lymphoma (NHL). Primary gastric anaplastic lymphoma kinase (ALK) negative ALCL is extremely rare. Diagnosis of primary gastric ALK-negative ALCL is difficult to establish and prognosis is worse than ALK-positive ALCL. Here, we report a case of an 82-year-old man with a history of cerebrovascular disease presented with weakness and iron deficiency anemia. He denied any abdominal discomforts. The esophagogastroduodenoscopy revealed a large ulcerated, friable mass in the gastric body which encompassed about 80% of entire stomach. Biopsy showed a high grade malignant tumor composed of undifferentiated epithelioid atypical cells, making it difficult to determine the cell of origin. Immunostains for lymphoma, carcinoma, and sarcoma were performed. The tumor cells were positive for CD30, CD4, and CD43, negative for CD20, CD3, ALK-1 and Epstein-Barr virus (EBV)-encoded small RNAs (EBERs) in situ hybridization, establishing the diagnosis of primary gastric ALK-negative ALCL. The patient is currently undergoing chemotherapy with clinical improvement. To the best of our knowledge, this is the first reported case of primary gastric ALK-negative and EBV-negative anaplastic large T-cell lymphoma that presented without gastroenterological symptoms.
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Affiliation(s)
- Wei Zhang
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Samuel Burton
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Shaobin Wu
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Xia Qian
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Mhd Nabeel Rajeh
- Division of Hematoloy and Medical Oncology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Katie Schroeder
- Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Mark Shuldberg
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Adam Merando
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Jin-Ping Lai
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO, U.S.A. .,Department of Pathology, Immunology and Laboratory Medicine, University of Florida, College of Medicine, Gainesville, FL, U.S.A
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50
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Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon neoplasia occurring in women with either cosmetic or reconstructive breast implants. The actual knowledge about BIA-ALCL deriving from the literature presents several limits, and it remains difficult to make inferences about BIA-ALCL epidemiology, cause, and pathogenesis. This is the reason why the authors decided to organize an evidence-based consensus conference during the Maurizio Bruno Nava (MBN 2016) Aesthetic Breast Meeting held in Milan in December of 2016. Twenty key opinion leaders in the field of plastic surgery from all over the world have been invited to express and discuss their opinion about some key questions on BIA-ALCL, trying to reach a consensus about BIA-ALCL cause, pathogenesis, diagnosis, and treatment in light of the actual best evidence.
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