A Leukemic Change as an Initial Manifestation of the Common Variant Type of ALK-Positive Anaplastic Large Cell Lymphoma in a Patient with Lung Adenocarcinoma

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Author(s)

    • Asai Satomi
    • Department of Laboratory Medicine, Tokai University School of Medicine
    • Yabe Miharu
    • Department of Laboratory Medicine, Tokai University School of Medicine
    • Hayama Naoki
    • Department of Medicine, Tokai University School of Medicine
    • Kondo Yusuke
    • Department of Medicine, Tokai University School of Medicine
    • Urano Tetsuya
    • Department of Medicine, Tokai University School of Medicine
    • Miyachi Hayato
    • Department of Laboratory Medicine, Tokai University School of Medicine

Abstract

We report an 81-year-old man who had leukemic presentation of ALK-positive anaplastic large cell lymphoma (ALCL) as an initial manifestation. He had been well after chemotherapy and irradiation for the advanced lung adenocarcinoma, but suddenly suffered from severe lactic acidosis and hypotension. The peripheral blood smear and bone marrow aspiration revealed the infiltration of atypical large cells with horseshoe-shaped or lobulated nuclei. The detection of CD30 expression and the t (2;5) (p23;q35) translocation in these cells was confirmatory of a diagnosis of common variant ALK-positive ALCL in a leukemic phase. He deteriorated rapidly and died before administration of the chemotherapy. An adequate, prompt diagnosis is necessary for this rare disease status in oncologic emergency to improve the disease management.<br>

Journal

  • Internal Medicine

    Internal Medicine 47(23), 2057-2062, 2008

    The Japanese Society of Internal Medicine

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