title: Cytomorphology of ALK+ anaplastic large cell lymphoma displaying spindle cells mimicking a sarcomatous tumor: report of a case.
abstract: Anaplastic large cell lymphoma (ALCL) is a lymphoma of T-cell or null-cell lineage characterized by molecular abnormalities involving anaplastic lymphoma kinase (ALK) gene and expression of ALK protein and CD30. Cytologic diagnosis of this entity is often a challenge and diagnostic difficulties are encountered when cytomorphology deviates from the usual descriptions. The reports of FNAC diagnosis of ALCL are rather limited. Histology and immunohistochemistry are usually required to confirm the diagnosis. We discuss a case of ALCL suspected on cytology in which a differential diagnosis of soft tissue sarcoma was also considered because of the presence of spindle-shaped and strap cells. Histology and immunohistochemistry confirmed the diagnosis of ALK+ ALCL with tumor cells displaying strong immunoreactivity for leucocyte common antigen, CD3, ALK-1 and CD30. We emphasize that the cytological features which may help in distinguishing sarcomatoid ALCL from soft tissue sarcoma are the presence of "hallmark cells," lymphoglandular bodies and admixed mature small lymphocytes.
authors.affiliation: Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, UP, India-226014.
authors.forename: Mukul
authors.initials: M
authors.lastname: Vij
authors.forename: Bonnie
authors.initials: B
authors.lastname: Dhir
authors.forename: Ritu
authors.initials: R
authors.lastname: Verma
authors.forename: Vinita
authors.initials: V
authors.lastname: Agrawal
authors.forename: Vikas
authors.initials: V
authors.lastname: Agarwal
authors.forename: Sushila
authors.initials: S
authors.lastname: Jaiswal
authors.forename: Rakesh
authors.initials: R
authors.lastname: Pandey
mesh_terms: D000293:Adolescent; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D006680:HLA Antigens / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D008297:Male; D020794:Receptor Protein-Tyrosine Kinases / Q000032:analysis / Q000378:metabolism*; D012509:Sarcoma / Q000175:diagnosis
chemical_list: D014408:Biomarkers, Tumor; D006680:HLA Antigens; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases