title: Simultaneous occurrence of a CD30 positive/ALK-negative high grade T-cell lymphoma and plasma cell myeloma: Report of a case.
abstract: Simultaneous occurrences of T-cell and B-cell neoplasms are rare, and etiological relationships between these two malignancies are poorly understood. We report the case of a 76-year-old man who presented with hypercalcemia, multiple skin nodular lesions, fatigue, episodic fever, and night sweats. PET/CT scan showed diffuse skin and subcutaneous fat plane active lesions, supra- and infra- diaphragmatic active lymph nodes, liver and spleen involvement, bone marrow infiltration, and nonspecific bilateral lung nodules. A skin biopsy showed a high grade CD30-positive/ALK-negative T-cell lymphoma. A bone marrow biopsy showed involvement by the same neoplastic cells. Additionally, a monoclonal lambda restricted plasma cell population (15% of marrow elements) was identified, which, in view of an IgA lambda spike in the serum, was consistent with plasma cell myeloma. To the best of our knowledge, this case is the first reported case of a plasma cell neoplasm associated with an aggressive CD30-positive ALK-negative systemic T-cell lymphoma with skin involvement. Reporting such cases is important as it adds to the pool of rare cases of concomitant T-cell neoplasms and plasma cell myelomas, and might help in determining an etiological relationship, if any, between these two hematological malignancies.
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: sn22@aub.edu.lb.
authors.forename: Samer
authors.initials: S
authors.lastname: Nassif
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Nadim
authors.initials: N
authors.lastname: El-Majzoub
authors.affiliation: Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Ossama
authors.initials: O
authors.lastname: Abbas
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Sally
authors.initials: S
authors.lastname: Temraz
authors.affiliation: Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Zaher
authors.initials: Z
authors.lastname: Chakhachiro
mesh_terms: D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D006801:Humans; D017730:Ki-1 Antigen / Q000096:biosynthesis; D016399:Lymphoma, T-Cell / Q000378:metabolism / Q000473:pathology*; D008297:Male; D009101:Multiple Myeloma / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D020794:Receptor Protein-Tyrosine Kinases / Q000096:biosynthesis
chemical_list: D017730:Ki-1 Antigen; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases