结节状ALK阳性间变性大细胞淋巴瘤一例

患者女,43岁.因双侧颈部和腹股沟淋巴结肿大伴发热,于2007年6月至江苏省人民医院.体检示双侧颈部和腹股沟淋巴结肿大,活动度差,直径约2～3 cm.因患者伴发热,不能明确为感染性疾病或淋巴造血系统肿瘤,遂取颈部淋巴结1枚活检.     

乳腺原发性ALK阳性间变性大细胞淋巴瘤1例

<正>患者女性,59岁。2020年6月体检发现乳腺肿物,超声示:右侧乳腺外上象限见一大小1.2 cm×0.9 cm×0.8 cm的极低回声结节,边界尚清,内见血流信号(BI-RADS 4A类),腋下未见肿大淋巴结。患者未重视,2021年4月自觉乳腺肿物增大,鸡蛋大小,且腋下见一鹌鹑蛋大小结节,并出现腋下疼痛、憋胀,放射至右上肢,遂行乳腺及腋下淋巴结穿刺活检。病理诊断:(右侧乳腺及腋下淋巴结穿刺组织)ALK阳性的间变性大细胞淋巴瘤。     

类似结节硬化型Hodgkin淋巴瘤的ALK阳性的间变性大细胞性淋巴瘤

间变性大细胞性淋巴瘤(ALCL)和Hodgkin淋巴瘤(HL)虽然是两种具有不同生物学行为的独立的疾病实体,但有时这两种疾病的形态学特征比较相似,该诊断带来了困难。作者从其收集的380例ALCL中发现有10例具有Hodgkin样特点,其中男性7例,女性3例,年龄3~92岁,平均年龄11岁。病变位于颈部     

CD30阴性/ALK阳性的间变性大细胞淋巴瘤一例

患者女,5岁.2010年1月初开始出现高热,间断发热,最高可达41 ℃,伴有乏力、呼吸困难,抗感染治疗效果不佳.1月中旬发现双侧颈部淋巴结同时肿大,大小约1.7 cm×2.0 cm×3.0 cm,质中偏硬,压痛,活动度差.2月初入院B超检查:双侧颈部、腋窝、纵隔内、腹股沟及腹腔内多发淋巴结肿大,脾肿大.于2010年2月20日外院切取颈部淋巴结活检.患者血常规正常.当地医院考虑为非霍奇金淋巴瘤,形态学怀疑T细胞淋巴瘤,建议外院会诊.     

原发性胃间变性淋巴瘤激酶阳性的间变性大细胞淋巴瘤一例

患者女,36岁.2个月前无明显诱因出现上腹持续性钝痛,无放射性痛,与进食无明显关系,无烧心、恶心、呕血,有黑便1次,于2009年12月12日入院.患者3个月前足月顺产一男婴.胃镜示:糜烂性胃炎,糜烂性十二指肠炎(肿物在黏膜下,位于十二指肠球部前壁,可见半球形隆起,表面见霜斑样糜烂).入院7 d前出现头晕、乏力、心悸.遂行远端胃大部切除+淋巴结清扫术+胆囊切除术,术中见肿瘤位于胃窦部,侵破浆膜层,侵及胰头、胆囊,其周围多发肿大淋巴结,且有淋巴结包绕肝总动脉及门静脉,十二指肠尚可,胆总管无增宽.切除远端胃、胆囊、胃网膜右及肝左动脉旁淋巴结送病理检查.     

胆囊ALK阴性间变性大细胞淋巴瘤1例

正患者男性,25岁,因反复右上腹痛1个月入院。患者为先天愚型21三体综合征。CT检查示胆囊结石伴胆囊炎,无肝脾肿大。在外院行胆囊切除术,术中见胆囊明显水肿,其内充满结石。切除标本送病理检查。病理检查眼观:胆囊1枚,大小6 cm×3 cm,囊内充满混合性结石数十枚,壁厚0.8 cm,局灶囊壁增厚,内壁粗糙。镜检:肿瘤组织弥漫分布,侵犯胆囊壁肌层(图1),部分肿瘤组织浸润血管壁,肿瘤细胞体积中等大小且形态多样,胞质     

中枢神经系统ALK阴性间变性大细胞淋巴瘤1例

<正>患者男性,40岁,因颈肩部酸痛伴四肢麻木乏力半个月入院。MRI加增强扫描示C3~C6水平硬脊膜增厚强化,C7椎体附件及邻近软组织、C3~C7水平右侧项部软组织多发异常信号,考虑硬脊膜来源恶性肿瘤累及C7椎体、附件及C3-C7水平右侧项部软组织,原始神经外胚层肿瘤可能(图1)。病理检查眼观:3 cm×2 cm×2 cm大小灰白色碎组织     

间变性淋巴瘤激酶阳性的大B细胞淋巴瘤一例

患者男,32岁.因左颈部肿块伴低热2个月于2008年5月入院.体检:双侧腋下、腹股沟淋巴结肿大.CT示双侧颈部、腋下、腹股沟多发肿大淋巴结.骨髓活检及实验室检查未见特殊.遂行左颈部淋巴结切取活检. 病理检查:淋巴结一枚,大小2.0 cm×1.5 cm×1.5 cm.镜下观察:淋巴结内肿瘤细胞呈弥漫浸润性生长方式,由免疫母或浆母样细胞组成,具有圆形淡染的核,显著中位核仁,胞质丰富,嗜双色性.     

下颌牙龈ALK阴性间变性大细胞淋巴瘤1例

正患者男性,79岁,因"左侧下颌牙龈疼痛1个月,伴牙龈肿大15天"就诊。体格检查:左侧下颌后牙区牙龈肿大,大小3 cm×2 cm×1 cm,触诊乒乓球样感,质中,压痛,与周围组织粘连,黏膜色泽正常,肿块界限尚可,后缘到翼下颌皱襞区,颊侧缘到前庭沟处,腭侧缘到左侧舌侧翼缘区,#38叩(+),Ⅲ度松动,盲袋较浅。行牙龈肿块摘除术,术中见肿块侵犯到颊侧肌肉层,底部下颌骨已破坏,远中达咽前壁。     

间变性大细胞Ki-1阳性非何杰金淋巴瘤一例

患者男，8岁。因双侧颈部淋巴结肿大伴发热4O天，干1995年1月27日就诊。患者于就诊前1个月时发现双侧颈部淋巴结肿大，以左侧为著；同时伴发热，最高达4OC，每日下午较重。在当地曾服退热药及抗生素无效。食欲及活动正常，二便无特殊，无关节疼痛。在外院曾诊断为“恶组”、“恶性淋巴瘤待排除”。既往无结核、肝炎等传染病史，无异常家族史。体检；体温39C，血压正常，脉搏118次／分，双颈部多个淋巴结肿大如蚕豆大小。左侧稍大，质硬，可活动。右锁骨上及腋下淋巴结如蚕豆大小肿大。胸骨无压痛，于右肋下可触及肝，于在肋下可触及脾。实…     

ALK-positive anaplastic large cell lymphoma with an unusual alveolar growth pattern

Anaplastic large cell lymphoma (ALCL) possesses a broad morphological spectrum. Currently, we present a case of ALK-positive ALCL presenting with an alveolar growth pattern in a 22-year-old Chinese female. This patient complained of a progressively enlarged mass in the right axillary region for 6 months. Excisional biopsy revealed a well-developed alveolar structure with nests of dyscohesive tumor cells separated by delicate fibrovascular septae. The large pleomorphic cells have irregular nuclei with prominent nucleoli and fine chromatin and abundant pale cytoplasm. The neoplasm stained positively for CD2, CD3ε, CD30, ALK1, EMA and cytotoxic molecules (TIA1 and Granzyme B). Cytogenetic study via interphase Fluorescence in-Situ Hybridization disclosed the rearrangement involving ALK gene. The patient received 6 cycles of CHOP chemotherapy and achieved complete remission. She is alive in good condition up to the present. Our case is biologically similar to the conventional ALK-positive ALCLs and may just represent an unusual morphological appearance.     

ALK-positive anaplastic large cell lymphoma in a patient with chronic lymphocytic leukemia

This article reports the case of a 59-year-old patient with an 8-year history of chronic lymphocytic leukemia (CLL), prostate carcinoma, and squamous cell carcinoma who developed an ALK-positive anaplastic large cell lymphoma (ALCL). Lymph node and bone marrow biopsies showed 2 distinct morphologic populations: (a) the CLL component showing a diffuse monomorphous infiltrate of small lymphocytes with the typical immunophenotype showing positive CD20, CD5, CD23, and κ light chain restriction and (b) the ALCL component showing large anaplastic pleomorphic cells positive for CD30, CD45, ALK, CD45Ro, CD4, and vimentin. Polymerase chain reaction performed on the lymph node for immunoglobulin heavy chain and T-cell receptor γ and β showed gene rearrangements after macrodissection of morphologically distinct populations, indicating confirmed genetically distinct populations. Despite intensive chemotherapy, the patient died. This case represents the rare occurrence of an ALK-positive ALCL developing in a patient with CLL.     

ALK-positive anaplastic large cell lymphoma with primary bone involvement in children

We describe the clinical, radiologic, and pathologic features of primary bone anaplastic large cell lymphoma (ALCL) in 3 boys. Radiologic imaging showed lytic lesions involving sacrum, femur, or rib. Bone was the only site of disease in 2 cases; an associated partial lymph node was involved in case 3. Differential diagnoses included osteomyelitis and small round cell tumors of childhood, particularly Ewing sarcoma. Preoperatively, ALCL was not a diagnostic consideration in any case. Two cases showed classic large pleomorphic cells; 1 showed a composite pattern with a distinct small cell component and the more typical large cell type. Neoplastic cells in all cases showed strong CD30 and anaplastic lymphoma kinase expression with relatively weak epithelial membrane antigen positivity. Cytotoxic granule protein was expressed in 2 cases. All cases showed unusually strong expression of neuron-specific enolase (NSE). Two patients were disease-free at last follow-up (15 months and 11 years); 1 patient died of disseminated disease within a year of diagnosis. ALCL should be considered a diagnostic possibility when evaluating neoplastic bone lesions in children. Although expression of NSE in ALCL has not been emphasized in the literature, it is worth noting because it may pose a diagnostic pitfall.     

肉芽肿性皮肤松弛症继发间变性大细胞淋巴瘤一例

患者男,37岁.2006年4月因四肢及臀部出现肿胀及皮下结节就诊,结节部位肢体增粗、肿胀,质硬,边界不清.行左下肢肌肉活检病理检查,多家医院会诊后考虑为肉芽肿性肌炎.给予泼尼松等药物治疗,症状有所好转,表现为结节部位变软,肢体肿胀有所减轻,但结节无缩小.