title: ALK-positive anaplastic large cell lymphoma with soft tissue involvement in a young woman.
abstract: BACKGROUND
  Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin lymphoma that has strong expression of CD30. ALCL can sometimes involve the bone marrow, and in advanced stages, it can produce destructive extranodal lesions. But anaplastic large cell lymphoma kinase (ALK)+ ALCL with soft tissue involvement is very rare.
  
  
  METHODS
  A 35-year-old woman presented with waist pain for over 1 month. The biopsy of soft tissue lesions showed that these cells were positive for ALK-1, CD30, TIA-1, GranzymeB, CD4, CD8, and Ki67 (90%+) and negative for CD3, CD5, CD20, CD10, cytokeratin (CK), TdT, HMB-45, epithelial membrane antigen (EMA), and pan-CK, which identified ALCL. After six cycles of Hyper-CVAD/MA regimen, she achieved partial remission. Three months later, she died due to disease progression.
  
  
  CONCLUSIONS
  This case illustrates the unusual presentation of ALCL in soft tissue with a bad response to chemotherapy. Because of the tendency for rapid progression, ALCL in young adults with extra-nodal lesions are often treated with high-grade chemotherapy, such as Hyper-CVAD/MA.
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Kehai
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Caihong
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Huazhuang
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Fang
authors.affiliation: Department of Orthopaedics, Yidu Central Hospital, Shandong, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Tian
keywords: ALK+; Hyper-CVAD/MA; anaplastic large cell lymphoma; soft tissue involvement