title: Primary lymphohistiocytic variant of anaplastic large cell lymphoma of the stomach.
abstract: Here, we report an unusual case of gastric anaplastic large cell lymphoma (ALCL), lymphohistiocytic variant, in a 70-year-old female patient who presented with epigastric pain, tarry stool and body weight loss. Endoscopic and imaging findings revealed a Bormann type II tumor in the stomach with perigastric lymphadenopathy and multiple tumor nodules in the liver. Total gastrectomy and liver biopsy were performed. Histologically, both gastric and hepatic tumors demonstrated anaplastic large neoplastic cells scattered among numerous reactive histiocytes. Immunostaining of these tumor cells reacted positively for CD30, CD3, CD45 RO/UCHL1, and negatively for epithelial membrane antigen, CD68, lysozyme, CD15, CD79a, CD138, PAX5 and anaplastic lymphoma kinase. Both the morphologic and immunophenotypic findings supported the diagnosis of gastric ALCL of lymphohistiocytic variant with liver metastasis. This patient then received chemotherapy and was still alive after 17 months of follow-up, without evidence of residual disease.
authors.affiliation: Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Chii-Shuenn
authors.initials: CS
authors.lastname: Yang
authors.forename: Guan
authors.initials: G
authors.lastname: Chou
authors.forename: Yee-Jee
authors.initials: YJ
authors.lastname: Jan
authors.forename: John
authors.initials: J
authors.lastname: Wang
authors.forename: Dah-Cherng
authors.initials: DC
authors.lastname: Yeh
authors.forename: Chieh-Lin
authors.initials: CL
authors.lastname: Teng
mesh_terms: D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D005260:Female; D006644:Histiocytes / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D011505:Protein-Tyrosine Kinases / Q000032:analysis; D020794:Receptor Protein-Tyrosine Kinases; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases