title: Fine-needle aspiration cytology yield as a basis for morphological, molecular, and cytogenetic diagnosis in alk-positive anaplastic large cell lymphoma with atypical clinical presentation.
abstract: ALK positive anaplastic large cell lymphoma is a T-cell lymphoma usually occurring in children and young adults. It frequently involves lymph nodes and extranodal sites and is associated with favorable prognosis. A 20-year old man was admitted for painful mass in the left axilla with overlying skin redness. Clinical presentation and US findings were highly suspicious for sarcoma. Definitive diagnosis was established cytolologically and using ancillary technologies from cytological samples. Fine needle aspiration cytology of tumor mass (lymph node conglomerate and surrounding tissue) show predominance of large, pleomorphic, atypical cells with large nuclei and vacuolised cytoplasm. Atypical cells immunocytochemically were positive for LCA, CD30, CD3, EMA, and ALK; negative for CD15 and CD56. NPM-ALK transcript was detected by reverse transcriptase-polymerase chain reaction (RT-PCT). Molecular analysis of TCRß and TCRγ genes demonstrated clonal TCR genes rearrangement. Complex karyotype with multiple numerical and structural changes was found on conventional cytogenetics. These findings excluded sarcoma and corroborated the diagnosis of ALK positive ALCL. Cutaneous involvement in ALCL can clinically mimic sarcoma, especially in cases with localized disease without B symptoms. In those cases, immunostaining, PCR, and conventional cytogenetics are helpful to exclude sarcoma. Diagn. Cytopathol. 2017;45:51-54. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Cytology and Cytogenetic, University Hospital Merkur, Zagreb, Croatia.
authors.forename: Maja
authors.initials: M
authors.lastname: Bogdanic
authors.affiliation: School of Medicine, University of Zagreb, Croatia.|Department of Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Slobodanka
authors.initials: S
authors.lastname: Ostojic Kolonic
authors.affiliation: Department of Cytology and Cytogenetic, University Hospital Merkur, Zagreb, Croatia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Kaic
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Merkur, University Hospital, Zagreb, Croatia.
authors.forename: Mirjana Mariana
authors.initials: MM
authors.lastname: Kardum Paro
authors.affiliation: Department of Pediatrics, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Ruzica
authors.initials: R
authors.lastname: Lasan Trcic
authors.affiliation: Department of Cytology and Cytogenetic, University Hospital Merkur, Zagreb, Croatia.|School of Medicine, University of Zagreb, Croatia.
authors.forename: Ika
authors.initials: I
authors.lastname: Kardum-Skelin
mesh_terms: D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D006801:Humans; D059785:Karyotype; D017728:Lymphoma, Large-Cell, Anaplastic / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008297:Male; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics; D012509:Sarcoma / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
keywords: ALCL; ALK+; ALK-positive; FNAC; anaplastic large cell lymphoma; fine-needle aspiration cytology; soft tissue sarcoma