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    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong. chancl@ha.org.hk
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antigens, CD / metabolism
Diagnosis, Differential
Female
Humans
Immunoenzyme Techniques
Immunophenotyping
Lymphoma, Large-Cell, Anaplastic / diagnosis*,  enzymology
Male
Middle Aged
Pleural Effusion, Malignant / diagnosis*,  enzymology
Protein-Tyrosine Kinases / metabolism
Chemical
Reg. No./Substance:
0/Antigens, CD; EC 2.7.10.1/Protein-Tyrosine Kinases; EC 2.7.10.1/anaplastic lymphoma kinase

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