CD13-positive anaplastic large cell lymphoma of T-cell origin - A diagnostic and histogenetic problem: A case report and review of the literature

N. K. Popnikolov, D. A. Payne, S. D. Hudnall, H. K. Hawkins, M. Kumar, B. A. Norris, M. T. Elghetany

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Abstract

The expression of myelomonocytic-associated antigens in anaplastic large cell lymphomas (ALCLs), particularly those presenting in extranodal sites, can make their distinction from extramedullary myeloid cell tumors (EMCTs) or histiocytic tumors problematic. Yet, this distinction is clinically significant because of its therapeutic and prognostic implications. Herein, we describe a case of extranodal anaplastic lymphoma kinase-positive CD30-positive ALCL of T-cell origin in a 12-year-old boy, which was initially called an EMCT because of the expression of CD13 and HLA-DR detected by flow cytometry and the absence of other T-cell-related surface markers. However, the detection of cytoplasmic CD3 by flow cytometry prompted further studies. The tumor was composed of large cells with abundant slightly eosinophilic vacuolated cytoplasm and ovoid or reniform nuclei with a few small nucleoli. Using immunohistochemistry, the tumor was positive for CD45, CD30, CD45RO, and CD43 with a strong cytoplasmic and nuclear anaplastic lymphoma kinase stain. The tumor cells showed a T-cell clonal genotype. Electron microscopy revealed no ultrastructural features of myelomonocytic or histiocytic origin. The patient responded well to the chemotherapy and was in complete remission for 10 months at the time of submission of this manuscript. Review of the literature showed inconsistencies regarding the diagnosis, nomenclature, and, therefore, treatment and prognosis of these tumors. In addition, the CD13 expression in ALCL raises some histogenetic questions and may indicate origin from a pluripotent stem cell, misprogramming during malignant transformation, or a microenvironmental effect on lymphoid cell expression of surface antigens. Therefore, ALCL should be considered in the differential diagnosis of EMCTs or histiocytic tumors, particularly when surface marker lineage assignment is ambiguous.

Original languageEnglish (US)
Pages (from-to)1804-1808
Number of pages5
JournalArchives of Pathology and Laboratory Medicine
Volume124
Issue number12
StatePublished - 2000

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Anaplastic Large-Cell Lymphoma
Myeloid Sarcoma
T-Lymphocytes
Neoplasms
Flow Cytometry
Pluripotent Stem Cells
HLA-DR Antigens
Surface Antigens
Terminology
Electron Microscopy
Cytoplasm
Differential Diagnosis
Coloring Agents
Immunohistochemistry
Genotype
Lymphocytes
Antigens
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Popnikolov, N. K., Payne, D. A., Hudnall, S. D., Hawkins, H. K., Kumar, M., Norris, B. A., & Elghetany, M. T. (2000). CD13-positive anaplastic large cell lymphoma of T-cell origin - A diagnostic and histogenetic problem: A case report and review of the literature. Archives of Pathology and Laboratory Medicine, 124(12), 1804-1808.

CD13-positive anaplastic large cell lymphoma of T-cell origin - A diagnostic and histogenetic problem : A case report and review of the literature. / Popnikolov, N. K.; Payne, D. A.; Hudnall, S. D.; Hawkins, H. K.; Kumar, M.; Norris, B. A.; Elghetany, M. T.

In: Archives of Pathology and Laboratory Medicine, Vol. 124, No. 12, 2000, p. 1804-1808.

Research output: Contribution to journalArticle

Popnikolov, NK, Payne, DA, Hudnall, SD, Hawkins, HK, Kumar, M, Norris, BA & Elghetany, MT 2000, 'CD13-positive anaplastic large cell lymphoma of T-cell origin - A diagnostic and histogenetic problem: A case report and review of the literature', Archives of Pathology and Laboratory Medicine, vol. 124, no. 12, pp. 1804-1808.
Popnikolov, N. K. ; Payne, D. A. ; Hudnall, S. D. ; Hawkins, H. K. ; Kumar, M. ; Norris, B. A. ; Elghetany, M. T. / CD13-positive anaplastic large cell lymphoma of T-cell origin - A diagnostic and histogenetic problem : A case report and review of the literature. In: Archives of Pathology and Laboratory Medicine. 2000 ; Vol. 124, No. 12. pp. 1804-1808.
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