Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(S 01): S169-S172
DOI: 10.4103/ijmpo.ijmpo_153_17
Case Report

ALK-Negative Anaplastic Large-Cell Lymphoma Diagnosed on Liver Biopsy in a Child Presenting with Nonresolving Pyrexia

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
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
   Permissions and Reprints

Abstract

ALK-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.

Keywords

ALK-negative - anaplastic large-cell lymphoma - extranodal - liver biopsy - lymphoma


Publication History

Article published online:
24 May 2021

© 2019. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Mason DY, Harris NL, Delsol G, Stein H, Campo E, Kinney MC. et al. Anaplastic large cell lymphoma, ALK-negative. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H. et al. editors WHO Classification of Tumors of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon: IARC; 2008: 317-9
    Google Scholar
  • 2 Ferreri AJ, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-negative. Crit Rev Oncol Hematol 2013; 85: 206-15
    CrossrefPubMedGoogle Scholar
  • 3 Agnelli L, Mereu E, Pellegrino E, Limongi T, Kwee I, Bergaggio E. et al. Identification of a 3-gene model as a powerful diagnostic tool for the recognition of ALK-negative anaplastic large-cell lymphoma. Blood 2012; 120: 1274-81
    CrossrefPubMedGoogle Scholar
  • 4 Xu X. ALK-negative anaplastic large cell lymphoma primarily involving the bronchus: A case report and literature review. Int J Clin Exp Pathol 2014; 7: 460-3
    PubMedGoogle Scholar
  • 5 Tsavari A, Koulia K, Skafida E, Myoteri D, Zisi A, Grammatoglou X. et al. Primary anaplastic large-cell lymphoma, ALK1 negative, of the liver: A case report. OA Case Rep 2013; 2: 20
    Google Scholar
  • 6 Mishra P, Dang M, Gajendra S, Lipi L, Sachdev R. Primary pancreatic ALK negative anaplastic large cell lymphoma. Pathology 2015; 47: 85-6
    CrossrefPubMedGoogle Scholar
  • 7 Mosunjac MB, Sundstrom JB, Mosunjac MI. Unusual presentation of anaplastic large cell lymphoma with clinical course mimicking fever of unknown origin and sepsis: Autopsy study of five cases. Croat Med J 2008; 49: 660-8
    CrossrefPubMedGoogle Scholar
  • 8 Wellmann A, Thieblemont C, Pittaluga S, Sakai A, Jaffe ES, Siebert P. et al. Detection of differentially expressed genes in lymphomas using cDNA arrays: Identification of clusterin as a new diagnostic marker for anaplastic large-cell lymphomas. Blood 2000; 96: 398-404
    CrossrefPubMedGoogle Scholar
  • 9 Bonzheim I, Geissinger E, Roth S, Zettl A, Marx A, Rosenwald A. et al. Anaplastic large cell lymphomas lack the expression of T-cell receptor molecules or molecules of proximal T-cell receptor signaling. Blood 2004; 104: 3358-60
    CrossrefPubMedGoogle Scholar
  • 10 ten Berge RL, Oudejans JJ, Ossenkoppele GJ, Meijer CJ. ALK-negative systemic anaplastic large cell lymphoma: Differential diagnostic and prognostic aspects – A review. J Pathol 2003; 200: 4-15
    CrossrefPubMedGoogle Scholar
  • 11 Savage KJ, Harris NL, Vose JM, Ullrich F, Jaffe ES, Connors JM. et al. ALK-anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ALCL and peripheral T-cell lymphoma, not otherwise specified: Report from the international peripheral T-cell lymphoma project. Blood 2008; 111: 5496-504
    CrossrefPubMedGoogle Scholar