title: Sarcomatoid variant of anaplastic large cell lymphoma mimicking a primary breast cancer: a challenging diagnosis.
abstract: The sarcomatoid variant of anaplastic large cell lymphoma is one of the rarest histologic variants of this neoplasm. Due to its sarcomatoid features, it is frequently misdiagnosed as a poorly differentiated sarcoma, anaplastic carcinoma, or melanoma. We report the case of a 92-year-old woman with a sarcomatoid anaplastic large cell lymphoma mimicking a primary breast neoplasm. The patient presented with a rapidly enlarging lump in the left breast and nodules in the right axilla. The immunohistochemical profile showed reactivity for leukocyte common antigen, UCHL-1, vimentin, and CD30, but immunoexpression of anaplastic lymphoma kinase was lacking. Anaplastic large cell lymphomas are lymphoid neoplasms of T-cell/null-cell lineage that consistently express the activation marker CD30 and usually carry a gene rearrangement of the anaplastic lymphoma kinase gene. To the best of our knowledge, this is the first reported case of sarcomatoid anaplastic large cell lymphoma presenting as a primary breast neoplasm in which anaplastic lymphoma kinase expression was assessed.
authors.affiliation: Salomão & Zoppi Associated Pathologists, Porto, Portugal.
authors.forename: Emílio M
authors.initials: EM
authors.lastname: Pereira
authors.forename: Sueli A
authors.initials: SA
authors.lastname: Maeda
authors.forename: Jorge S
authors.initials: JS
authors.lastname: Reis-Filho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017730:Ki-1 Antigen / Q000032:analysis; D017493:Leukocyte Common Antigens / Q000032:analysis; D017728:Lymphoma, Large-Cell, Anaplastic / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D012509:Sarcoma / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D014746:Vimentin / Q000032:analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D017730:Ki-1 Antigen; D014746:Vimentin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D017493:Leukocyte Common Antigens; D008727:Methotrexate