Abstract: |
Diffuse large B-cell lymphoma (DLBCL) with plasmablastic features associated with t(2;17)(p23;q23) and characteristic granular cytoplasmic anaplastic lymphoma kinase-1 (ALK1) protein expression is a rare lymphoma subtype. Nodal and extranodal involvement has been reported. Our case is a 32-year-old man with right cervical adenopathy. Lymph node biopsy showed large atypical cells with prominent plasmablastic differentiation, abundant amphophilic cytoplasm, and prominent central nucleoli. Paraffin immunohistochemistry showed finely granular cytoplasmic ALK1 expression, positive CD138, IgA, p63 (VS38), focal positive epithelial membrane antigen and CD4, and λ light chain restriction whereas negative CD20 and CD30 staining. While reports show detection of the unique CLTC-ALK fusion by either reverse transcription-polymerase chain reaction or fluorescence in situ hybridization, our case represents the second case in the literature to detect the t(2;17)(p23;q23) translocation by multiplex karyotyping (multiplex fluorescence in situ hybridization) and the usefulness of this technique to detect hidden translocations not seen by G-banding. An add(2)(p23) was also seen not previously reported. Differential diagnoses of neoplasms with plasmablastic differentiation and a comprehensive molecular/cytogenetic literature review of ALK + DLBCL is discussed. Copyright © 2009 by Lippincott Williams & Wilkins. |
Keywords: |
immunohistochemistry; adult; human tissue; protein expression; prednisone; case report; doxorubicin; cancer combination chemotherapy; cancer radiotherapy; cancer diagnosis; in situ hybridization, fluorescence; reverse transcription polymerase chain reaction; computer assisted tomography; diagnosis, differential; cyclophosphamide; vincristine; cell differentiation; chromosomes, human, pair 2; cd20 antigen; fluorescence in situ hybridization; cellular distribution; cytoplasm; translocation, genetic; protein p63; large cell lymphoma; lymphoma, large b-cell, diffuse; cd4 antigen; karyotyping; lymph node biopsy; cd30 antigen; alk; epithelial membrane antigen; cd57 antigen; clathrin; dlbcl; npm; plasmablastic; t(2; 5); 7)(p23; q23); anaplastic lymphoma kinase; immunoglobulin a; syndecan 1; cervical lymphadenopathy; activin receptors, type ii; chromosomes, human, pair 17
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