Primary cerebral anaplastic large cell lymphoma containing abundant reactive histiocytes and eosinophils. A case report and literature review.
Primary cerebral anaplastic large cell lymphoma (ALCL) is very rare. We report on our experience with such a case and review the literature. A 46-year-old Taiwanese woman presented with headache, weakness of her right extremity, and limited eye movement. A solid mass (5 cm x 4 cm) at the left occipital lobe was almost completely removed. The neoplastic cells, some of which had reniform or embryo-like nuclei, were large and were admixed with abundant eosinophils, histiocytes, and some small lymphocytes. These neoplastic cells expressed CD30, CD43, granzyme B and T-cell intracellular antigen-1, but not ALK1, CD3, CD20, CD45, CD79a, cytokeratin, and EMA. They were positive for Epstein-Barr virus-encoded mRNA by in situ hybridization. Polymerase chain reaction study of formalin-fixed tissue showed a clonal gene arrangement of the T-cell receptor-gamma chain. ALCL of T-cell lineage with cytotoxic phenotype was diagnosed. The patient received cranial irradiation and has remained with no evidence of disease for 25 months of follow-up.
Chuang
S S
SS
Department of Pathology, Chi-Mei Foundation Hospital, Yung Kang City, Tainan County, Taiwan. ssc6061@ms16.hinet.net
Huang
W
W
Lin
C N
CN
Chio
C C
CC
Tsai
T C
TC
Li
C Y
CY
Shen
C H
CH
D001932:Brain Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000628:therapy / Q000821:virology; D003399:Craniotomy; D004273:DNA, Neoplasm / Q000032:analysis; D004804:Eosinophils / Q000473:pathology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006644:Histiocytes / Q000473:pathology*; D006801:Humans; D007121:Immunocompetence; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D017730:Ki-1 Antigen / Q000032:analysis; D017728:Lymphoma, Large-Cell, Anaplastic / Q000737:chemistry / Q000473:pathology* / Q000628:therapy / Q000821:virology; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D016601:RNA-Binding Proteins / Q000032:analysis; D018714:Radiotherapy, Adjuvant; D012269:Ribosomal Proteins; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D004273:DNA, Neoplasm; D017730:Ki-1 Antigen; D012367:RNA, Viral; D016601:RNA-Binding Proteins; D012269:Ribosomal Proteins; C067169:RPL22 protein, human