Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders—mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK– ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.
SteinH, MasonDY, GerdesJ, et al.The expression of Hodgkin’s disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cell. Blood. 1985;66:3681-95.
Mason DY, Harris NL, Delsol G, et al. Anaplastic large cell lymphoma, ALK-negative. In: Swerdlow SCE, Campo E, Harris NL, et al., editors. WHO classification of tumors of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 317-9.
Delson G, Falini B, Muller-Hermelink HL, et al. Anaplastic large cell lymphoma, ALK-positive. In: Swerdlow SCE, Campo E, Harris NL, et al., editors. WHO classification of tumors of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 312-6.
MosunjacMB, SundstromBJ, MosunjacMI. Unusual presentation of anaplastic large cell lymphoma with clinical course mimicking fever of unknown origin and sepsis: Autopsy study of five cases. Croat Med J. 2008;49:660-8. http://dx.doi.org/ [https://doi.org/10.3325/cjm.2008.5.660]
CamposFPF, Felipe-SilvaA, ZerbiniMCN. Anaplastic large cell lymphoma ALK-negative clinically mimicking alcoholic hepatitis - a review. Autopsy Case Rep [Internet]. 2013;3(3):11-9. http://dx.doi.org/ [https://doi.org/10.4322/acr.2013.023]
TaniaiH, FurusyoN, MurataM, et al.A case report of human immunodeficiency virus-associated anaplastic lymphoma kinase protein-negative anaplastic large cell lymphoma. SpringerPlus. 2013;2:400-5.
CastilloJ, BeltranBE, BibasM, et al.Prognostic factors in patients with HIV-associated peripheral T-cell lymphoma: a multicenter study. Am J Hematol. 2011;86:256-61. http://dx.doi.org/ [https://doi.org/10.1002/ajh.21947]
CastilloJ, PerezK, MilaniC, DezubeBJ, PantanowitzL. Peripheral T-cell lymphomas in HIV-infected individuals: a comprehensive review. J HIV Ther. 2009;14:34-40.
HaradaY, YamadaS, MurakamiS, et al.Ki-1 lymphoma with nodular involvement in liver and spleen: possible role of cytokines in systemic manifestation of fever and leukocytosis. Dig Dis Sci. 2000;45:2240-6.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email