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Santonja C, Morillo-Giles D, Prieto-Pareja E, Soto-de Ozaeta C, Serrano-del Castillo C, Salgado-Sánchez R, Yi-Shi AWY, Manso R, Rodríguez-Pinilla SM. Leukaemic Presentation of Small-Cell Alk-Positive Anaplastic Large Cell Lymphoma in a Young Woman-Report of a Case with 9-Year Survival. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1628. [PMID: 37763746 PMCID: PMC10537167 DOI: 10.3390/medicina59091628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) with leukaemic presentation (either ab initio or along the course of the disease) has been rarely reported. Irrespective of ALK expression in the neoplastic cells, it features a dismal prognosis. We report a rare case of leukaemic, small cell variant ALK-positive ALCL with 9-year survival in a young woman who was treated upfront with corticosteroids and standard chemotherapy, and review thoroughly the previously published cases. Such an unexpected, good outcome hints at the existence of different clinical subgroups in the leukaemic variant of ALK-positive ALCL.
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Affiliation(s)
- Carlos Santonja
- Departments of Pathology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (C.S.); (A.-W.-Y.Y.-S.); (S.M.R.-P.)
| | - Daniel Morillo-Giles
- Departments of Haematology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (D.M.-G.); (E.P.-P.); (C.S.-d.O.); (C.S.-d.C.); (R.S.-S.)
| | - Elena Prieto-Pareja
- Departments of Haematology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (D.M.-G.); (E.P.-P.); (C.S.-d.O.); (C.S.-d.C.); (R.S.-S.)
| | - Carlos Soto-de Ozaeta
- Departments of Haematology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (D.M.-G.); (E.P.-P.); (C.S.-d.O.); (C.S.-d.C.); (R.S.-S.)
| | - Cristina Serrano-del Castillo
- Departments of Haematology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (D.M.-G.); (E.P.-P.); (C.S.-d.O.); (C.S.-d.C.); (R.S.-S.)
| | - Rocío Salgado-Sánchez
- Departments of Haematology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (D.M.-G.); (E.P.-P.); (C.S.-d.O.); (C.S.-d.C.); (R.S.-S.)
| | - Ana-Wu-Yang Yi-Shi
- Departments of Pathology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (C.S.); (A.-W.-Y.Y.-S.); (S.M.R.-P.)
| | - Rebeca Manso
- Departments of Pathology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (C.S.); (A.-W.-Y.Y.-S.); (S.M.R.-P.)
| | - Socorro María Rodríguez-Pinilla
- Departments of Pathology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain; (C.S.); (A.-W.-Y.Y.-S.); (S.M.R.-P.)
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Angioimmunoblastic T-Cell Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: A Novel Form of Composite Lymphoma Potentially Mimicking Richter Syndrome. Am J Surg Pathol 2021; 45:773-786. [PMID: 33739791 DOI: 10.1097/pas.0000000000001646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is an indolent small B-cell neoplasm that may transform into a clinically aggressive disease, namely Richter syndrome, usually as diffuse large B-cell lymphoma. Besides, CLL/SLL encompasses an increased risk of developing other secondary cancers, including a variety of T-cell lymphomas, often of the anaplastic large-cell type or with a cytotoxic phenotype. Here, we report a small series of patients with composite lymphomas consisting of CLL/SLL and angioimmunoblastic T-cell lymphoma (AITL), a hitherto unrecognized association. The 3 patients (1 male/2 females, 68 to 83 y) presented with high-grade-type symptoms. One patient was clinically suspicious for Richter syndrome, in the others CLL/SLL and AITL were concomitant de novo diagnoses. CLL/SLL and AITL were admixed in the same lymph nodes (3/3 cases) and in the bone marrow (1/2 cases). In all cases, the AITL comprised prominent clear cells with a strong T follicular helper immunophenotype and similar mutations consisting of TET2 or DNMT3A alterations, IDH2 R172K/M, and RHOA G17V. The 3 patients received chemotherapy. One died of early AITL relapse. The other 2 remained in complete remission of AITL, 1 died with recurrent CLL, and 1 of acute myeloid leukemia. These observations expand the spectrum of T-cell lymphoma entities that occur in association with CLL/SLL, adding AITL to the rare variants of aggressive neoplasms manifesting as Richter syndrome. Given that disturbances of T-cell homeostasis in CLL/SLL affect not only cytotoxic but also helper T-cell subsets, these may contribute to the emergence of neoplasms of T follicular helper derivation.
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3
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The management of breast implant-associated anaplastic large cell lymphoma in the setting of pregnancy: seeking for clinical practice guidelines. Arch Plast Surg 2021; 48:373-377. [PMID: 34352947 PMCID: PMC8342241 DOI: 10.5999/aps.2021.00185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/27/2021] [Indexed: 11/08/2022] Open
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The aim of this paper is to report the first case of BIA-ALCL diagnosed in a pregnant patient. It is well known that BIA-ALCL appears as an indolent lymphoma with a good prognosis when diag-nosed at early stages and clinical guidelines for its management have been clearly published. Nevertheless, they lack a standardized approach for BIA-ALCL during pregnancy. With limited experience in our case, treatment has been safely postponed after term without affecting patient’s overall prognosis and without fetal complication. The fact that the disease was diagnosed at an early stage (stage I) undoubtedly influenced the course of treatment. A multidisciplinary approach weighing the risks and benefits of treatment is of paramount importance in order to ensure the best possible outcome for both the mother and her child and clinical update guidelines should be issued.
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Yang S, Jiang WM, Yang HL. ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report. World J Clin Cases 2019; 7:2857-2863. [PMID: 31616703 PMCID: PMC6789405 DOI: 10.12998/wjcc.v7.i18.2857] [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: 06/13/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy.
CASE SUMMARY We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up.
CONCLUSION ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy; therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed.
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Affiliation(s)
- Sen Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Wei-Min Jiang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
| | - Hui-Lin Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
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Amante MA, Galagnara SJP, Ignacio J. Anaplastic large cell lymphoma in a pregnant Filipino woman successfully treated with prepartum and postpartum chemotherapy. BMJ Case Rep 2018; 2018:bcr-2018-225576. [PMID: 30209141 DOI: 10.1136/bcr-2018-225576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Diagnosis of a malignancy during pregnancy presents a dilemma regarding the work-up and treatment of the patient. This report presents a 42-year-old woman on her 23rd week of pregnancy with multiple enlarging fungating violaceous skin masses. Biopsy of the dominant mass revealed anaplastic large cell lymphoma. Due to the progressive enlargement and increase in number of the masses, the patient was given two cycles of chemotherapy (doxorubicin, vincristine, cyclophosphamide and prednisone) before delivering a live baby boy via spontaneous vaginal delivery, Apgar 9.9, at 37 4/7 weeks. After delivery, she completed four more cycles of treatment. A full-body positron emission tomography scan done 2 months after the last chemotherapy showed no evidence of disease. The patient is doing well with no evidence of disease 9 months after treatment. Her baby is thriving and has no gross deformities and no developmental delays.
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Affiliation(s)
- Madelaine Amurao Amante
- Section of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Sharon Jane Pingol Galagnara
- Section of Perinatology, Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jorge Ignacio
- Section of Medical Oncology, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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Zecchini Barrese T, Sagramoso C, Bacci F, Sabattini E. Small cell variant of anaplastic large cell lymphoma with leukemic presentation: a diagnostic challenge. Rev Bras Hematol Hemoter 2017; 39:269-273. [PMID: 28830608 PMCID: PMC5568588 DOI: 10.1016/j.bjhh.2017.05.009] [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: 05/25/2015] [Revised: 03/24/2017] [Accepted: 05/18/2017] [Indexed: 11/01/2022] Open
Affiliation(s)
- Tomás Zecchini Barrese
- Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.
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Freerksen N, Kirschner M, Pecks U, Westphal S, Jost E, Maass N, Bauerschlag DO. Fulminant puerperal sepsis due to anaplastic large-cell lymphoma (ALCL) with therapy-refractory cerebral edema. Arch Gynecol Obstet 2014; 290:191-3. [PMID: 24563187 DOI: 10.1007/s00404-014-3171-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Lymphoma is among the five most frequent malignancies during pregnancy while anaplastic large-cell lymphoma (ALCL) is rare, accounting only for 2-3 % of all adult-onset non-Hodgkin lymphomas. CASE REPORT A 23-year-old gravida 1, para 1 presented with puerperal mastitis and septicemia following secondary cesarean section. Mastitis had been present for a week prior to delivery. A CT scan for further diagnostics revealed numerous prominent lymph nodes. Cerebrospinal fluid testing, bone marrow and lymph node biopsy confirmed diagnosis of ALCL. Systemic and intrathecal chemotherapy was initiated, stabilizing the patient's clinical situation. 30 days postpartum (pp.), a cerebral edema was diagnosed responsible for cerebro-venous hypoperfusion. Immediate ventricle drainage and further therapeutic measures revealed no improvement. The patient died 33 days pp. CONCLUSION Puerperal septicemia seemingly caused by mastitis still needs rapid further evaluation if the patient's clinical presentation quickly declines despite antibiotic therapy. Immediate initiation of chemotherapy after confirmation of ALCL is required to increase the therapeutic benefit due to the poor prognosis of ALCL.
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Affiliation(s)
- Nele Freerksen
- Department of Obstetrics and Gynecology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany,
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Spiegel A, Paillard C, Ducassou S, Perel Y, Plantaz D, Strullu M, Eischen A, Lutz P, Lamant L, Le Deley MC, Brugières L. Paediatric anaplastic large cell lymphoma with leukaemic presentation in children: a report of nine French cases. Br J Haematol 2014; 165:545-51. [PMID: 24666317 DOI: 10.1111/bjh.12777] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 12/02/2013] [Indexed: 12/13/2022]
Abstract
This study aimed to describe the clinical features and outcome of anaplastic large cell lymphoma (ALCL) with leukaemic presentation in children. Among 267 patients included in the French paediatric ALCL database between 1989 and 2012, nine (3%) were described as having cytologically detectable circulating tumour cells. Clinical features combined fever (8/9), nodal and extra-nodal disease (9/9), including hepato-splenic (9/9) and lung involvement (7/9). The level of hyperleucocytosis ranged from 30 to 120 × 10(9) /l, with 12-90% of tumour cells. Diagnosis relied on a lymph node biopsy, with a positive ALK+ antibody immunostain in all nine cases, a T-cell immunophenotype in 7/9 cases and CD3 positivity in 5/9 cases. A small cell component was present in 6/9 cases. Only four patients achieved a complete remission with first-line therapy and 3/4 relapsed. Four patients are alive with a median follow-up of 31 months, two of them after allogeneic haematopoietic stem cell transplantation (HSCT), and five patients died, two of them of disease. In conclusion, ALCL with leukaemic presentation is very unusual and should be considered as high-risk lymphoma requiring new therapeutic strategies. The respective role of new agents and allogeneic HSCT in first complete remission still has to be assessed.
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Affiliation(s)
- Alexandra Spiegel
- CHU de Strasbourg, Service d'hématologie oncologie pédiatrique, pédiatrie 3, Hopital Hautepierre, Strasbourg, France
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Reproductive organ involvement in non-Hodgkin lymphoma during pregnancy: a systematic review. Lancet Oncol 2013; 14:e275-82. [DOI: 10.1016/s1470-2045(12)70589-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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10
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Grandhi A, Boros AL, Berardo N, Reich RF, Freedman PD. Two cases of CD30+, anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma with oral manifestations. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e41-7. [DOI: 10.1016/j.oooo.2012.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 04/19/2012] [Accepted: 04/19/2012] [Indexed: 10/27/2022]
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11
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Imamura R, Mouri F, Nomura K, Nakamura T, Oku E, Morishige S, Takata Y, Seki R, Osaki K, Hashiguchi M, Yoshimoto K, Ohshima K, Nagafuji K, Okamura T. Successful treatment of small cell variant anaplastic large cell lymphoma with allogeneic peripheral blood stem cell transplantation, and review of the literature. Int J Hematol 2012; 97:139-43. [DOI: 10.1007/s12185-012-1242-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 12/04/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022]
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12
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Summers TA, Moncur JT. The small cell variant of anaplastic large cell lymphoma. Arch Pathol Lab Med 2010; 134:1706-10. [PMID: 21043827 DOI: 10.5858/2008-0624-rsr.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Anaplastic large cell lymphomas constitute a heterogeneous group of hematopoietic neoplasms that are characterized by immunopositivity for CD30 and the presence, in varying degrees, of large, pleomorphic "hallmark" cells. Primary systemic anaplastic lymphoma kinase-positive anaplastic large cell lymphomas are a subset of this group. Numerous heterogeneous histomorphologic patterns have been described in anaplastic lymphoma kinase-positive anaplastic large cell lymphomas, and all patterns tend to have a better prognosis than that found in anaplastic lymphoma kinase-negative cases. We provide a short review of the small cell variant of anaplastic large cell lymphoma to facilitate the diagnosis of this difficult-to-recognize entity, which may be confused with reactive processes, commonly presents with disseminated disease, and pursues an aggressive clinical course.
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Affiliation(s)
- Thomas A Summers
- Department of Pathology and Laboratory Services, Walter Reed Army Medical Center, Washington, DC, USA.
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13
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Youd E, Boyde AM, Attanoos RL, Dojcinov SD. Small cell variant of anaplastic large cell lymphoma: a 10-year review of the All Wales Lymphoma Panel database. Histopathology 2009; 55:355-8. [DOI: 10.1111/j.1365-2559.2009.03369.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Peccatori FA, Azim HA, Pruneri G, Piperno G, Raviele PR, Preda L, Ciocca M, Orecchia R, Martinelli G. Management of anaplastic large-cell lymphoma during pregnancy. J Clin Oncol 2009; 27:e75-7. [PMID: 19506155 DOI: 10.1200/jco.2009.22.2042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Fedro A Peccatori
- Department of Medicine, Division of Haematology-Oncology, European Institute of Oncology, Milan, Italy
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Grewal JS, Smith LB, Winegarden JD, Krauss JC, Tworek JA, Schnitzer B. Highly aggressive ALK-positive anaplastic large cell lymphoma with a leukemic phase and multi-organ involvement: a report of three cases and a review of the literature. Ann Hematol 2007; 86:499-508. [PMID: 17396261 DOI: 10.1007/s00277-007-0289-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Accepted: 03/13/2007] [Indexed: 11/29/2022]
Abstract
Anaplastic large cell lymphoma (ALCL) is an aggressive neoplasm of T- or null cell phenotype and is recognized as a distinct clinicopathologic subtype of non-Hodgkin lymphoma (NHL) in the revised World Health Organization (WHO) classification of hematopoietic neoplasms. It is rarely associated with leukemic phase. Most cases with leukemic involvement are the small cell variant of ALCL. These cases often lack the pleomorphism seen in the common variant of ALCL and may be misdiagnosed. We report a series of three patients who presented with leukemic phase ALCL. The patients included an 11-year-old boy, a 29-year-old man, and a 59-year-old woman. The clinical and pathologic features of these cases are reviewed. The patients in our case series with leukemic phase ALCL exhibited rare clinical features. The patients presented with massive extranodal disease involving cerebrospinal fluid (CSF), liver, spleen, lungs, and bone marrow. CSF involvement was documented morphologically as well as by flow cytometry in two patients. Two of the patients had small cell variant and the third patient had common type ALCL. The neoplastic cells in all three patients were ALK positive; however these patients died within months of diagnosis. Leukemic phase ALCL is rare, and behaves in an aggressive manner. Some, but not all, cases in the literature presenting with peripheral blood involvement had small cell variant ALCL, as seen in two of our cases. The leukemic phase of ALCL should be considered when a T-cell leukemia with unusual morphologic features is encountered.
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Affiliation(s)
- Jaspreet S Grewal
- Department of Internal Medicine, Reichert Health Center, St. Joseph Mercy Hospital, 5333 McAuley Drive Suite 3009, Ann Arbor, MI 48106-0995, USA.
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Lamant L, Espinos E, Duplantier M, Dastugue N, Robert A, Allouche M, Ragab J, Brousset P, Villalva C, Gascoyne RD, Al Saati T, Delsol G. Establishment of a novel anaplastic large-cell lymphoma-cell line (COST) from a ‘small-cell variant’ of ALCL. Leukemia 2004; 18:1693-8. [PMID: 15356659 DOI: 10.1038/sj.leu.2403464] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Anaplastic large-cell lymphoma (ALCL) is a distinct biological and cytogenetic entity with a broad spectrum of morphological features (common type, small-cell variant and lymphohistiocytic variant). Few cell lines of ALCL are available and they all originate from primary tumors demonstrating the common type morphology (ie large-sized lymphoma cells). We established a new ALCL cell line (COST) from the peripheral blood of a patient with a small-cell variant of ALCL, at diagnosis. Cells growing in vitro and in SCID mice consisted of two populations, that is, small- and large-sized cells as seen in the patient's tumor. Both large and small malignant cells were positive for CD43/MT1 T-cell associated antigen, perforin, granzyme B and TIA-1, but negative for CD2, CD3, CD5, CD7, CD4 and CD8 antigens. Standard cytogenetic studies as well as multiplex FISH confirmed the presence of the canonical t(2;5)(p23;q35) translocation, but also revealed additional numerical and structural abnormalities. The COST cell line is the first ALCL small-cell variant cell line, and thus provides a potentially useful tool for further functional and molecular studies that should improve our understanding of the small-cell variant of ALCL, which is more frequently complicated by a leukemic phase.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Child, Preschool
- Chromosome Aberrations
- Chromosomes, Human, Pair 2/genetics
- Chromosomes, Human, Pair 5/genetics
- Cytogenetic Analysis
- Female
- Gene Rearrangement, T-Lymphocyte
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- In Vitro Techniques
- Lymphoma, Large-Cell, Anaplastic/genetics
- Lymphoma, Large-Cell, Anaplastic/immunology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Male
- Mice
- Mice, SCID
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic
- Tumor Cells, Cultured
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Affiliation(s)
- L Lamant
- Department of Oncogenesis and Signaling in Hematopoietic Cells, Inserm U-563, Centre de Physiopathologie de Toulouse-Purpan, Toulouse, France
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Dereure O, Portales P, Balavoine M, Corbeau P, Guillot B, Clot J, Guilhou JJ. Rare occurrence of CD30+ circulating cells in patients with cutaneous CD30+ anaplastic large cell lymphoma: a study of nine patients. Br J Dermatol 2003; 148:246-51. [PMID: 12588375 DOI: 10.1046/j.1365-2133.2003.05020.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The presence of a significant percentage of circulating atypical lymphocytes in peripheral blood has already been demonstrated in systemic CD30+ anaplastic large cell lymphoma (ALCL), which implies that a leukaemic component may be present in this subset of lymphomas. However, no similar data are available for the cutaneous counterpart of this particular lymphoproliferation. OBJECTIVES To assess the presence of atypical cells, CD30+ lymphocytes and of a dominant T-cell clone in peripheral blood in a series of patients with cutaneous CD30+ ALCL. MATERIALS AND METHODS Nine patients with either primary (four) or secondary (five) cutaneous CD4+ CD30+ ALCL were selected. The percentage of CD30+ CD4+ lymphocytes among peripheral blood mononuclear cells (PBMC) was determined by flow cytometry and the presence of a dominant circulating T-cell clone was assessed by polymerase chain reaction targeting the T-cell receptor gamma chain. A control group composed of apparently healthy individuals was similarly studied at the same time. RESULTS The mean percentage of CD30+ cells in PBMC was slightly higher in patients than in controls (3.9% vs. 2.7%) but the difference was not statistically significant. Only two patients displayed more than 5% CD30+ cells, both of whom had a minor tumour burden. A dominant circulating T-cell clone was detected in only three cases, including these two latter patients. CONCLUSIONS The occurrence of a significant percentage of CD30+ CD4+ circulating cells is rare in active cutaneous CD30+ ALCL, either primary or secondary. This percentage is not related to the apparent skin tumour burden but a significant figure appeared to be correlated with the detection of a dominant T-cell clone in peripheral blood. Overall, these data show that, unlike mycosis fungoides, peripheral blood involvement seems infrequent in cutaneous CD30+ ALCL. The hypothesis that a high percentage of CD30+ circulating cells might be related to the presence of a cryptic systemic disease cannot be ruled out.
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Affiliation(s)
- O Dereure
- Department of Dermatology-Phlebology and Laboratory of Immunology, University Hospital of Montpellier, Hôpital Saint-Eloi, 2 avenue B. Sans, 34295 Montpellier Cedex 5, France.
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