Anaplastic large cell lymphoma, ALK-negative exhibiting rare CD4 [ +] CD8 [ +] double-positive immunophenotype

Abstract Anaplastic large cell lymphoma is a relatively rare type of T cell lymphoma characterized by strong and uniform CD30 expression with a typical cohesive growth pattern and hallmark cells. Most cases are single-positive for CD4 or less often CD8-positive, with only very rare descriptions of h...
Ausführliche Beschreibung

Abstract Anaplastic large cell lymphoma is a relatively rare type of T cell lymphoma characterized by strong and uniform CD30 expression with a typical cohesive growth pattern and hallmark cells. Most cases are single-positive for CD4 or less often CD8-positive, with only very rare descriptions of having double positivity for both antigens. Agent Orange is a herbicide which was used during the Vietnam War and has been associated with non-Hodgkin lymphoma (including chronic lymphocytic leukemia, hairy cell leukemia, and other chronic B cell leukemias), Hodgkin lymphoma and monoclonal gammopathy of undetermined significance. Herein, we describe a unique case of anaplastic large cell lymphoma ALK-negative arising in a military veteran with documented Agent Orange exposure featuring double positivity for both CD4 and CD8 with a brief literature review that highlights the uniqueness of this rare phenotype. Our patient underwent a left neck lymph node biopsy that was worked up for a lymphoproliferative process. Based on the diagnosis rendered, a T cell lymphoma fluorescence in situ hybridization [FISH] panel was done. T cell receptor gene rearrangement studies could not be performed due to consumption of the material. A core biopsy of the left neck lymph node showed an infiltrate of frankly malignant large lymphoid cells with many featuring eccentric horseshoe/kidney shaped nuclei with an eosinophilic region near the nucleus, consistent with hallmark cells with admixed small lymphocytes, plasma cells and few neutrophils and eosinophils. The neoplastic cells were positive for CD45, CD30, CD2 [subset +], CD5, and also showed double-positive [DP] CD4 + CD8 + and were negative for CD3. FISH studies for T cell lymphoma FISH panel that included rearrangements involving ALK, TP63 and DUPS22 [IRF4] gene regions were negative. Through this case, we demonstrate a unique case of anaplastic large cell lymphoma, ALK-negative in a patient with Agent Orange exposure and featuring double positivity for CD4 and CD8. Ausführliche Beschreibung

Autor*in:	Prabhakaran, Nitya [verfasserIn] Ward, Nicholas

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Anaplastic large cell lymphoma ALK-negative CD4 CD8 Agent Orange

Anmerkung:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Übergeordnetes Werk:	Enthalten in: Journal of hematopathology - Berlin : Springer, 2008, 15(2022), 4 vom: 12. Okt., Seite 249-253
Übergeordnetes Werk:	volume:15 ; year:2022 ; number:4 ; day:12 ; month:10 ; pages:249-253

Links:	Volltext

DOI / URN:	10.1007/s12308-022-00517-4

Katalog-ID:	SPR04888586X