Anaplastic large cell lymphoma: an unusual presentation in a 7-year-old girl

CD30-Positive Anaplastic Lymphoma Kinase-Negative Systemic Anaplastic Large-Cell Lymphoma in a 9-Year-Old Boy

Anaplastic large-cell lymphoma (ALCL) is a CD30-positive T-cell/null-cell lymphoma that is clinically classified into either primary cutaneous ALCL or systemic ALCL (S-ALCL) sub-types. Because 90% of childhood S-ALCL cases are anaplastic lymphoma kinase (ALK)-positive, there is a lack of data on ALK-negative S-ALCL cases among pediatric patients. Herein, we report a rare case of ALK-negative S-ALCL in a 9-year-old Korean boy who initially presented with itchy erythematous maculopapules and an erosive nodule on the trunk area. We emphasize the need of high index of suspicion of an underlying malignant disease in the presence of refractory eczematous lesions.

Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Manifesting as a Scalp Hematoma After an Acute Head Injury-a Case Report and Literature Review

BACKGROUND

Anaplastic large cell lymphoma (ALCL) is a malignant non-Hodgkin lymphoma, typically associated with anaplastic lymphoma kinase (ALK) expression. In some cases, lack of ALK translocation correlated with a more unfavorable prognosis.

CASE DESCRIPTION

We describe a case of ALK(-) ALCL that manifested as a progressive, enlarged, swollen mass on the scalp after an acute head injury in an 84-year-old man. Neither palpable lymph nodes nor any B symptoms were noted on admission. Brain computed tomography showed a hematoma in the right posterior occipital region of the scalp as the only remarkable finding. Débridement and biopsy were performed. Histologic and immunohistochemical analysis of the specimen revealed an ALK(-) ALCL of the scalp. The lymphoma was resistant to bendamustine-containing chemotherapies, ultimately leading to the patient's death within 2 months.

CONCLUSIONS

This case report highlights the importance of recognizing the possibility of an ALCL manifesting as a focal inflammatory swelling mass on the scalp.

Imprint cytology facilitating the diagnosis of primary cutaneous anaplastic large cell lymphoma of iliac fossa

Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a form of cutaneous T-cell lymphoma that is characterized by solitary nodules and plaques. In this report, the authors present an unusual case of a 59-year-old male with a solitary ulcerofungative mass in the left iliac fossa clinically masquerading as sqaumous cell carcinoma. The imprint smears of the lesion had characterstic morphological features which helped in the diagnosis. Subsequently, the imprint cytology correlated well with the histopathology and immunohistochemical studies highlighting its utility as simple, rapid, and easy test.

High-risk ALK negative anaplastic large-cell lymphoma presenting with hypereosinophilic syndrome in a 2.5-year-old child

The hypereosinophilic syndromes (HES) are characterized by prolonged nonreactive peripheral blood hypereosinophilia with tissue damage. The lymphocytic HES variant can precede malignant clonal T-cell disease in adults but it is extremely rare to be the presenting feature of lymphomas in children. Here we present a 2.5-year-old boy with HES and mediastinal T-cell anaplastic lymphoma kinase (ALK) negative systemic anaplastic large-cell lymphoma. Mature and immature eosinophils without blasts were shown on bone marrow aspiration while biopsy revealed malignant infiltration. The patient responded well to initial corticosteroid therapy, but high-risk features make a challenge of finding the cure in this extremely rare case.