CASE REPORT |
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Year : 2014 | Volume
: 4
| Issue : 1 | Page : 50-53 |
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Primary ALK positive Anaplastic large cell lymphoma of T-cell type of jejunum: Report of a rare extranodal entity with review of literature
Niamathullah Sadiya1, Mitra Ghosh2
1 Consultant Histopathologist, Department of Histopathology, SRM Institute for Medical Sciences, Chennai, Tamil Nadu, India 2 Senior Consultant and Head of Histopathology, SRM Institute for Medical Sciences, Chennai, Tamil Nadu, India
Correspondence Address:
Niamathullah Sadiya Department of Histopathology, New No 21, Flat no T1, Ameer Regency, Balaji Nagar, 2nd Street, Royapettah, Chennai - 600 014, Tamil Nadu India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/2278-9596.136716
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The gastrointestinal tract (GI tract) is the most common site for extranodal lymphomas with the majority of the non-Hodgkin's B-cell type. It involves any part of the GI, the most frequent sites in the order of occurrence are the stomach, small intestine, and ileocecal region. A 17-year-old male presented with intermittent abdominal pain, altered bowel habits associated with vomiting of 1 month duration. Computerized tomography of the abdomen revealed an eccentric mass in the jejunum with significant luminal narrowing. Limited resection of jejunum showed an intraluminal polypoidal growth with a homogenous cut surface. Microscopic examination of the mass revealed a diffusely infiltrating monotonous population of large lymphoid cells with round to oval vesicular nucleus, prominent nucleoli and moderate to scanty cytoplasm, admixed with few multinucleated giant cells with wreath like arrangement of nuclei, binucleated cells, and atypical mitosis. The tumor was involving the submucosa, infiltrating the muscularis propria and extending into the sub serosa. Immunohistochemistry showed diffuse positivity for CD45, CD30, anaplastic lymphoma kinase-1 (ALK-1), and focal positivity for CD43. The immunohistochemical stains for B-cell lineage CD20, CD79a, T-cell markers CD3, CD2, CD4, CD8, CD7, and other markers namely bcl2, bcl6, CD5, CD138, CD56, Mum1, and PAX-5 were negative. Six lymph nodes isolated showed features of reactive follicular hyperplasia and were free of tumor. A diagnosis of primary ALK positive anaplastic large cell lymphoma of T-cell type of jejunum was made. Patient has completed three cycles of chemotherapy comprising of cyclophosphamide, prednisone, vincristine, and doxorubicin and is in remission until the last follow-up. |
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