Chronic myeloid leukemia as a secondary malignancy after ALK-positive anaplastic large cell lymphoma |
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Authors: | Alsop Skylar Sanger Warren G Elenitoba-Johnson Kojo S J Lim Megan S |
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Affiliation: | a Department of Pathology, Penn State University, Hershey, PA 16802, USA b Department of Human Genetics Laboratories, Munroe-Meyer Institute, Nebraska Medical Center, Omaha, NE 68198, USA c Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA |
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Abstract: | The development of Philadelphia chromosome-positive chronic myelogenous leukemia (CML) in the adolescent population is very rare. CML occurring as a secondary malignancy in individuals treated for anaplastic large cell lymphoma (ALCL) is also rare. We present the case of a 16-year-old adolescent boy who developed a right orbital mass that was diagnosed as ALCL with the t(2;5)(p23;q25) chromosomal aberration. Four years after receiving treatment for ALCL, he presented with a swollen leg and a white cell count of 431,000. Peripheral blood and bone marrow evaluation revealed a myeloproliferative disorder. Cytogenetic and molecular studies demonstrated the presence of t(9;22). We present the histopathologic, molecular, and cytogenetic findings of this patient's initial presentation with systemic ALCL as well as his secondary presentation with CML 4 years later. Therapy-related CML and non-therapy-related secondary CML are discussed as potential explanations of this highly unusual clinical presentation. |
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Keywords: | Chronic myeloid leukemia Therapy Anaplastic large cell lymphoma |
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