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Cytokeratin in anaplastic large cell lymphoma
H F Frierson1, F J Bellafiore, M J Gaffey
1Department of Pathology, University of Virginia Health Sciences Center, Charlottesville.
Insights
Anaplastic large cell lymphoma cells were found to express cytokeratins, which are typically found in epithelial cells. This unexpected finding in lymphoma complicates diagnosis and highlights potential cellular origin confusion.
Area of Science:
- Oncology
- Cell Biology
- Immunohistochemistry
Background:
- Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin lymphoma.
- Diagnosis typically relies on lymphoid markers, but some cases present diagnostic challenges.
Observation:
- Neoplastic cells in a B-cell ALCL case showed immunoreactivity for cytokeratins.
- Cytokeratin expression was confirmed by immunohistochemistry and Western blot analysis.
- Cytokeratin-positive fibroblastic reticulum cells were also present in the lymph node.
Findings:
- The malignant cells synthesized cytokeratins, rather than merely phagocytosing them from surrounding cells.
- Specific cytokeratins identified included cytokeratin 18 and cytokeratins 18 and 8.
- This cytokeratin expression is an infrequent but notable characteristic of ALCL.
Implications:
- The presence of cytokeratins in ALCL can lead to diagnostic confusion due to their epithelial origin.
- This finding contributes to understanding the pleomorphic nature of ALCL.
- Further research may clarify the role and origin of cytokeratins in lymphoid neoplasms.
Abstract:
A B-cell anaplastic large cell lymphoma, confirmed by immunohistochemistry and Southern blot immunoglobulin gene rearrangement analysis, contained neoplastic cells that were immunoreactive for cytokeratin using antibodies CAM 5.2, M20, MAK 6, and KS-B17.2. Bands corresponding to cytokeratin 18 and cytokeratins 18 and 8 were seen on Western blot immunoanalysis using antibodies KS-B17.2 and CAM 5.2. The lymph node also contained cytokeratin-positive extrafollicular fibroblastic reticulum cells. Although it is possible that the presence of cytokeratin in the cells of anaplastic large cell lymphoma represented phagocytosed filaments from the reticulum cells, it is more likely that the cytokeratins were synthesized by the malignant cells. The finding of cytokeratin in anaplastic large cell lymphoma, although infrequent, adds to the confusion in the diagnosis of this pleomorphic neoplasm.
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