Anaplastic large-cell lymphoma of null-cell type with multiple bone involvement.
A 21-year-old man who had anaplastic large cell lymphoma (ALCL) of the null-cell type with multiple bone involvement is reported. On admission, he had symptoms of incomplete paraplegia and urinary and rectal incontinence. Workup studies for staging revealed para-aortic lymph node swellings and multiple bone involvement including skull, ribs, left iliac bone, and thoracic/lumbar spine. Because paraplegia was rapidly progressive, a decompression operation was performed. The biopsy specimen obtained from the lumbar spine revealed sheetlike proliferation of anaplastic large cells. These cells were positive for CD30 (Ki-1), EMA, vimentin, and p80NPM/ALK, and negative for CD3, CD20 (L26), and CD45 (LCA). Epstein-Barr virus-encoded small RNAs were not detectable in these cells. Thus, the patient was diagnosed as having ALCL of the null-cell type. He was treated with several courses of combination chemotherapy, and finally with total body irradiation plus high-dose chemotherapy supported by peripheral blood stem cell transplantation. However, soon after the treatment, the lymphoma cells massively infiltrated his bone marrow. He died of lymphoma 8 months after admission.
Suzukawa
K
K
Division of Hematology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Kojima
H
H
Mori
N
N
Mukai
H Y
HY
Hori
M
M
Komeno
T
T
Hasegawa
Y
Y
Ninomiya
H
H
Nagasawa
T
T
D000328:Adult; D001859:Bone Neoplasms / Q000503:physiopathology*; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000503:physiopathology*; D008297:Male