title: Anaplastic lymphoma kinase-positive anaplastic large cell lymphoma presenting as a bladder neoplasm.
abstract: Malignant lymphoma presenting in the bladder has been classified in primary cases, as the first sign of disseminated disease and as a secondary infiltration. Most of the examples in the literature have been reported as single cases. Reported herein is the case of a 45-year-old man with an anaplastic large cell lymphoma (anaplastic lymphoma kinase (ALK) and granzyme B positive) that presented as a bladder neoplasm. The morphological differential diagnosis was complex because the EMA-positive immunophenotype, CD45 and CD3 negativity and the clinical manifestation simulated a transitional cell carcinoma. It is important to be aware of its existence because a poorly differentiated bladder carcinoma cannot be ruled out if CD30 and ALK immunostaining are not performed. T-cell receptor-gamma clonal rearrangement could be also helpful in these cases. Although bladder involvement by recurrent lymphoma is a sign of widely disseminated disease and it is associated with a very poor prognosis, it seems that chemotherapeutic regimens in this kind of ALK-positive lymphoma could be effective, given that the present patient had an impressive response to chemotherapy treatment.
authors.affiliation: Pathology Department, University Hospital Marqués de Valdecilla, Cantabria Health Service, Medicine Faculty, Cantabria University, Santander, Spain. apagrj@humv.es
authors.forename: José Javier
authors.initials: JJ
authors.lastname: Gómez-Román
authors.forename: María Luisa Cagigal
authors.initials: ML
authors.lastname: Cobo
authors.forename: José Fernando
authors.initials: JF
authors.lastname: Val-Bernal
mesh_terms: D000077548:Anaplastic Lymphoma Kinase; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000378:metabolism; D002945:Cisplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D017730:Ki-1 Antigen / Q000378:metabolism; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D011505:Protein-Tyrosine Kinases / Q000378:metabolism*; D020794:Receptor Protein-Tyrosine Kinases; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D017730:Ki-1 Antigen; D018396:Mucin-1; D003561:Cytarabine; D005047:Etoposide; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases; D002945:Cisplatin; D008775:Methylprednisolone