Anaplastic large cell lymphoma of the mediastinum diagnosed by transbronchial scratch cytology. A case report.
BACKGROUND
Anaplastic large cell lymphoma (ALCL) is a subtype of non-Hodgkin's lymphoma characterized by CD30 antigen-positive, large neoplastic cells. We describe a case of ALCL suggested by cytologic examination of the tumor cells obtained from bronchial scratch preparations.


METHODS
A 26-year-old woman had had a dry cough since November 1996. Chest radiography in May 1997 revealed an abnormal shadow in the mediastinum extending to the pulmonary hilar region. The patient was hospitalized in June 1997. Computed tomography revealed a neoplastic lesion in the anterior mediastinum invading the right lung. Transbronchial scratch cytology revealed large, atypical lymphoid cells expressing CD30 and CD3 on immunocytochemical examination. A transcutaneous mediastinal biopsy was performed and a diagnosis of ALCL made.


CONCLUSIONS
Differentiation from Hodgkin's disease was the most difficult point in this case. Detailed cytologic observation and CD3-positive immunocytology led to the correct diagnosis. The cell transfer technique of Sherman et al was very useful for immunocytologic staining. Thus, transbronchial scratch cytology was an especially valuable and effective procedure in this case.
Kayao
Junko
J
Departments of Pathology and Internal Medicine, Clinical Laboratory, Narita Red Cross Hospital, 90-1 Iida-cho, Narita, Chiba 286-8523, Japan.
Tamaru
Jun-ichi
J
Wakita
Hisasi
H
Saitou
Tadasi
T
Kuzuu
Yoshihiko
Y
Mikata
Atsuo
A
Tanaka
Noboru
N
D000328:Adult; D001706:Biopsy; D001980:Bronchi / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000473:pathology*; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000473:pathology*