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Anaplastic large cell lymphoma presenting as a pleural effusion and mimicking primary effusion lymphoma. A report of 2 cases.
- Source :
-
Acta cytologica [Acta Cytol] 2003 Sep-Oct; Vol. 47 (5), pp. 809-16. - Publication Year :
- 2003
-
Abstract
- Background: Systemic anaplastic large cell lymphoma (ALCL) is predominantly a nodal disease, but extranodal involvement can occur during the disease course or as the primary presentation. We report two rare cases of ALCL presenting with a pleural effusion, mimicking primary effusion lymphoma (PEL).<br />Cases: Two patients, a 47-year-old woman and an 81-year-old man, presented with a pleural effusion for investigation. The pleural fluid contained abundant, large, lymphoid cells with marked nuclear atypia. These neoplastic cells strongly expressed CD30 and EMA and showed a T-cell phenotype (CD3+CD45RO+ for case 1 and CD4+ for case 2). Case 1, in addition, showed ALK1 expression. The tumor cells in both cases were negative for human herpes virus type 8 (HHV8) and Epstein-Barr virus (EBV). ALCL shows overlapping cytologic features with PEL, but the T-cell phenotype, ALK1 expression in case 1, lack of association with HHV8 and EBV, HIV seronegativity and subsequent discovery of nodal disease in case 2 were all in favor of ALCL over PEL.<br />Conclusion: In rare cases a pleural effusion is the presenting feature of ALCL, and distinction from PEL depends on correlation with clinical findings, detailed immunophenotyping and study of the status of HHV8 and EBV.
- Subjects :
- Aged
Aged, 80 and over
Anaplastic Lymphoma Kinase
Antigens, CD metabolism
Diagnosis, Differential
Female
Humans
Immunoenzyme Techniques
Immunophenotyping
Lymphoma, Large-Cell, Anaplastic enzymology
Male
Middle Aged
Pleural Effusion, Malignant enzymology
Protein-Tyrosine Kinases metabolism
Receptor Protein-Tyrosine Kinases
Lymphoma, Large-Cell, Anaplastic diagnosis
Pleural Effusion, Malignant diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0001-5547
- Volume :
- 47
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Acta cytologica
- Publication Type :
- Academic Journal
- Accession number :
- 14526684
- Full Text :
- https://doi.org/10.1159/000326611