Document Detail

Anaplastic large cell lymphoma presenting as a pleural effusion and mimicking primary effusion lymphoma. A report of 2 cases.
MedLine Citation:
PMID:  14526684     Owner:  NLM     Status:  MEDLINE    
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).
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.
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.
Alexander Chak-Lam Chan; John Kwok-Cheung Chan; Kin Wing Yan; Yok Lam Kwong
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta cytologica     Volume:  47     ISSN:  0001-5547     ISO Abbreviation:  Acta Cytol.     Publication Date:    2003 Sep-Oct
Date Detail:
Created Date:  2003-10-06     Completed Date:  2003-10-17     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  0370307     Medline TA:  Acta Cytol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  809-16     Citation Subset:  IM    
Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
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MeSH Terms
Aged, 80 and over
Antigens, CD / metabolism
Diagnosis, Differential
Immunoenzyme Techniques
Lymphoma, Large-Cell, Anaplastic / diagnosis*,  enzymology
Middle Aged
Pleural Effusion, Malignant / diagnosis*,  enzymology
Protein-Tyrosine Kinases / metabolism
Reg. No./Substance:
0/Antigens, CD; EC Kinases; EC lymphoma kinase

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