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Brady AL, Fuller CE, Patel S, Hall W, Banki K, Ghimire KB. Primary CNS ALK-negative anaplastic large cell lymphoma: A case report and review of the literature. Radiol Case Rep 2024; 19:393-399. [PMID: 38033666 PMCID: PMC10682537 DOI: 10.1016/j.radcr.2023.09.095] [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: 07/02/2023] [Accepted: 09/27/2023] [Indexed: 12/02/2023] Open
Abstract
Primary central nervous system (CNS) ALK-negative anaplastic large cell lymphoma (ALCL) is a rare and enigmatic disease, with limited data available in the literature. This case report adds to the existing body of knowledge by describing a unique case of a 68-year-old, immunocompetent male who presented with a single ring-enhancing lesion, which upon further analysis proved to be an ALK-negative ALCL that was primary to the CNS. A comprehensive review of the existing literature is provided, highlighting the genetic characteristics and diverse neuroimaging findings of this disease entity. This report adds valuable information to the understanding of this rare disorder, and highlights the need for further research in the field of primary CNS ALK-negative ALCL.
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Affiliation(s)
- Amy L. Brady
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Sohil Patel
- Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA
| | - Walter Hall
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Katalin Banki
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Krishna B. Ghimire
- Department of Medicine, Hematology and Medical Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
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2
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Colamaria A, Leone A, Carbone F, Dallos Laguado YA, Fochi NP, Sacco M, Fesce C, Sanguedolce F, Giordano G, Iaconetta G, Spetzger U, Coppola L, De Santis E, Coppola G, De Notaris M. Primary Anaplastic-Lymphoma-Kinase-Positive Large-Cell Lymphoma of the Central Nervous System: Comprehensive Review of the Literature. J Clin Med 2023; 12:7516. [PMID: 38137585 PMCID: PMC10743784 DOI: 10.3390/jcm12247516] [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: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Primary anaplastic-lymphoma-kinase (ALK)-positive large-cell lymphoma of the central nervous system (PCNS ALK-positive ALCL) is a rare entity, with a limited consensus reached regarding its management. While this pathology often presents as solitary lesions, the occurrence of multiple tumors within the brain is not uncommon. The lack of distinctive radiological features poses a diagnostic challenge, leading to delays in initiating targeted therapy. METHODS We conducted a comprehensive literature search, identifying seventeen publications for qualitative analysis. RESULTS The management options and reported patient outcomes in the literature varied significantly, emphasizing the need for a patient-specific approach. The emergence of ALK-specific inhibitors represents a new frontier in this field, demonstrating promising results. CONCLUSION PCNS ALK-positive ALCL necessitates a comprehensive understanding and optimized management strategies. A tailored therapeutic approach, integrating surgical intervention with radiotherapy and chemotherapy, appears pivotal in addressing this pathology. The implementation of a therapeutic protocol is anticipated for further advancement in this field.
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Affiliation(s)
- Antonio Colamaria
- Division of Neurosurgery, Policlinico “Riuniti”, 71122 Foggia, Italy;
| | - Augusto Leone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
- Faculty of Human Medicine, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Francesco Carbone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | | | - Nicola Pio Fochi
- Division of Neurosurgery, University of Foggia, 71122 Foggia, Italy
| | - Matteo Sacco
- Division of Neurosurgery, “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy;
| | - Cinzia Fesce
- Hematology Unit, University Hospital, 71122 Foggia, Italy;
| | | | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Giorgio Iaconetta
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Uwe Spetzger
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | - Luigi Coppola
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic sciences, La Sapienza University, 00185 Roma, Italy;
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, La Sapienza University, 00185 Roma, Italy;
| | - Matteo De Notaris
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
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3
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Perillo T, Forte J, Messina R, Muggeo P, Grassi M, Pentassuglia E, Raguseo C, Ingravallo G, d'Amati A, Resta M, Speranzon L, Signorelli F, Santoro N. Primary central nervous system anaplastic large cell lymphoma in children: Case presentation and systematic review of literature. Pediatr Blood Cancer 2023; 70:e30529. [PMID: 37402611 DOI: 10.1002/pbc.30529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/18/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Teresa Perillo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Jessica Forte
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Raffaella Messina
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Paola Muggeo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Massimo Grassi
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Enza Pentassuglia
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Celeste Raguseo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Giuseppe Ingravallo
- Section of Pathology - Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro,", Bari, Italy
| | - Antonio d'Amati
- Section of Pathology - Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro,", Bari, Italy
| | - Mariachiara Resta
- Neuroradiology, University Hospital Policlinico of Bari, Bari, Italy
| | - Luca Speranzon
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Francesco Signorelli
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Nicola Santoro
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
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Ahrendsen JT, Ta R, Li J, Weinberg OK, Ferry JA, Hasserjian RP, Meredith DM, Varma H, Sadigh S, Michaels PD. Primary Central Nervous System Anaplastic Large Cell Lymphoma, ALK Positive. Am J Clin Pathol 2022; 158:300-310. [PMID: 35460414 DOI: 10.1093/ajcp/aqac046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Primary central nervous system anaplastic large cell lymphoma, anaplastic lymphoma kinase positive (primary CNS ALCL, ALK+) is a rare CNS lymphoma whose description is limited to case reports. These tumors have a variable clinical course, and prognosis is primarily determined by age. We present the largest case series to date of primary CNS ALCL, ALK+, with observational data. METHODS A retrospective search of multiple academic centers was performed to identify cases of primary CNS ALCL, ALK+. We also performed a review of published cases of primary CNS ALCL, ALK+. Clinical history, radiography, pathology, and genetic testing data were obtained to determine the prognostic implications in the context of clinical course. RESULTS We identified three cases of primary CNS ALCL, ALK+ from our databases. A literature review identified 30 published reports of 31 individual cases. Clinical features for the combined 34 cases included a median age of 18.5 years, with a male to female ratio of 4.7:1, and the most common symptom was headache. Genetic studies demonstrated an ALK rearrangement by fluorescence in situ hybridization, and a gene fusion assay confirmed an NPM1-ALK gene fusion in one case. CONCLUSIONS We present the largest case series to date of a rare primary CNS lymphoma with additional diagnostic and clinical information.
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Affiliation(s)
- Jared T Ahrendsen
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Oklahoma City Office of the Chief Medical Examiner, Oklahoma City, OK, USA
| | - Robert Ta
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Jingwei Li
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Olga K Weinberg
- University of Texas-Southwestern Medical Center, Dallas, TX, USA
| | - Judith A Ferry
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | | | - David M Meredith
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Hemant Varma
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sam Sadigh
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Phillip D Michaels
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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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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Liu Q, Chen X, Li G, Ye Y, Liu W, Zhao S, Zhang W. Primary central nervous system ALK-positive anaplastic large cell lymphoma with CD56 abnormally expression in a Chinese child: Challenge in diagnostic practice. Int J Immunopathol Pharmacol 2021; 34:2058738420941756. [PMID: 32664812 PMCID: PMC7364798 DOI: 10.1177/2058738420941756] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK + ALCL) is most frequent in youth and possesses a broad morphologic spectrum. However, involvement in central nervous system (CNS) is definitely rare. The case we presented was a 12-year-old Chinese male who presented with headache and emesis for a couple of days. The neoplastic component was smaller cells resembling starry-sky growth pattern and immunohistochemical stained positively for CD30, ALK1, and CD56. Monoclonal T-cell receptor (TCRγ) gene rearrangement and gene translocation involving ALK identified by fluorescence in situ hybridization (FISH) using ALK break apart probe supported the diagnosis of ALK + ALCL. This case showed ALK + ALCL occur in a rare site with an abnormal CD56 expression. Awareness of this entity is important to distinguish it from other intracranial lymphoma.
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Affiliation(s)
- Qian Liu
- Department of Pathology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.,Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Xian Chen
- Department of Pathology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Gandi Li
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Yunxia Ye
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Weiping Liu
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Sha Zhao
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
| | - Wenyan Zhang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
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Abstract
Primary lymphoid neoplasms of the central nervous system are rare tumors that span a wide range of histopathologic appearances and can overlap occasionally with non-neoplastic processes. Application of modern molecular techniques has not only begun to unravel their unique underlying biology but has also started to lay a valuable diagnostic and therapeutic framework for these frequently aggressive malignancies. This review summarizes the existing landscape of clinicopathologic and genomic features of lymphoid neoplasms that may arise primarily within the central nervous system.
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Affiliation(s)
- David M Meredith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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Fujisawa E, Shibayama H, Mitobe F, Katada F, Sato S, Fukutake T. [A case of primary central nervous system anaplastic lymphoma kinase positive anaplastic large cell lymphoma manifested as a unilateral pachymeningits]. Rinsho Shinkeigaku 2017; 57:705-710. [PMID: 29070753 DOI: 10.5692/clinicalneurol.cn-001030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There have been 23 reports of primary central nervous system anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma in the literature. Here we report the 24th case of a 40-year-old man who presented with occipital headache for one month. His contrast-enhanced brain MRI showed enhancement around the right temporal lobe, which suggested a diagnosis of hypertrophic pachymeningitis. He improved with steroid therapy. After discharge, however, he was readmitted with generalized convulsive seizures. Finally, he was diagnosed as primary central nervous system ALK-positive anaplastic large cell lymphoma by brain biopsy. Primary central nervous system lymphoma invading dura matter can rarely manifests as a unilateral pachymeningitis. Therefore, in case of pachymeningitis, we should pay attention to the possibility of infiltration of lymophoma with meticulous clinical follow-up.
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Affiliation(s)
| | | | - Fumi Mitobe
- Department of Neurology, Kameda Medical Center
| | | | - Susumu Sato
- Department of Neurology, Kameda Medical Center
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