title: Early molecular detection of central nervous system relapse in a child with systemic anaplastic large cell lymphoma: case report and review of the literature.
abstract: We report a case of anaplastic large cell lymphoma (ALCL) with central nervous system relapse in an 11-year-old boy. The relapse was suspected on morphologic examination of the cytospin preparations of the cerebrospinal fluid (CSF) with a WBC of 10 cells/microl. CSF relapse was confirmed using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and reverse transcriptase-polymerase chain reaction (RT-PCR) for abnormal ALK expression or gene structure. The patient developed large intracranial metastases, despite systemic, and intrathecal chemotherapy. This case demonstrates the feasibility of detecting ALCL in paucicellular CSF specimens and suggests that even low CSF involvement can herald massive parenchymal disease.
authors.affiliation: Division of Hematology and Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Armstrong
authors.forename: Arpad
authors.initials: A
authors.lastname: Szallasi
authors.forename: Jaclyn A
authors.initials: JA
authors.lastname: Biegel
authors.forename: Sheila
authors.initials: S
authors.lastname: Shurtleff
authors.forename: Larissa T
authors.initials: LT
authors.lastname: Bilaniuk
authors.forename: Richard B
authors.initials: RB
authors.lastname: Womer
authors.forename: John Kim
authors.initials: JK
authors.lastname: Choi
mesh_terms: D014408:Biomarkers, Tumor; D016543:Central Nervous System Neoplasms / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D002648:Child; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D017728:Lymphoma, Large-Cell, Anaplastic / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D014408:Biomarkers, Tumor