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ALK-negative anaplastic large cell lymphoma mimicking a soft tissue sarcoma
Rachel Hudacko1, Amy Rapkiewicz, Russell Scott Berman
1Department of Pathology, NYU Langone Medical Center, New York City, USA.
Journal of Cytology
|November 18, 2011
Summary
Anaplastic large cell lymphoma (ALCL) lacking anaplastic lymphoma kinase protein (ALK) can mimic other cancers. Accurate diagnosis on fine-needle aspiration (FNA) biopsy is possible with ancillary tests.
Area of Science:
- Hematopathology
- Cytopathology
- Oncology
Background:
- Anaplastic lymphoma kinase protein (ALK)-negative anaplastic large cell lymphoma (ALCL) presents a wide range of morphologic features.
- Cytologic and histologic features of ALK-negative ALCL can mimic other malignancies.
- Published literature on the cytomorphologic features of ALCL in fine-needle aspiration (FNA) biopsy specimens is limited.
Observation:
- A case of ALK-negative ALCL in a 62-year-old man mimicked a high-grade soft tissue sarcoma of the thigh.
- Morphologic findings on FNA and core biopsy were characteristic of ALCL.
- The immunophenotypic profile supported the diagnosis.
Findings:
- Diagnosis of ALK-negative ALCL on FNA biopsy can be challenging.
- Ancillary tests are crucial for successful diagnosis.
- Key morphologic findings include pleomorphism, anaplasia, and characteristic nuclear shapes (wreath-like or horseshoe-shaped).
Implications:
- ALK-negative ALCL should be considered in the differential diagnosis of ambiguous lesions.
- Adequate material for ancillary studies is essential for accurate diagnosis.
- Successful diagnosis of ALCL on FNA biopsy relies on a combination of morphology and immunophenotyping.
