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Ki-1 (CD30)-positive large cell lymphoma presented with leukemia: a case report
Insights
This case report details a rare leukemic phase of Ki-1 positive large cell lymphoma in a 77-year-old woman. The findings highlight the importance of considering this lymphoma in differential diagnoses for unexplained anemia and abnormal lymphoid cells.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Anaplastic large cell lymphoma (ALCL) is a distinct type of non-Hodgkin lymphoma.
- Ki-1 (CD30) positivity is a hallmark of ALCL, typically affecting lymph nodes.
- Leukemic presentation of ALCL is uncommon.
Observation:
- A 77-year-old woman presented with fatigue and fever, diagnosed with anemia and abnormal lymphoid cells.
- Peripheral blood and bone marrow revealed diffuse infiltration by these atypical lymphoid cells.
- Immunophenotypic analysis identified the cells as T-cell lineage, positive for CD30 (Ki-1), CD3, HLA-DR, and CD25.
Findings:
- The patient was diagnosed with the leukemic phase of Ki-1 positive large cell lymphoma.
- Differential diagnoses considered included acute megakaryocytic leukemia, malignant histiocytosis, and other lymphomas.
- The T-cell lineage was confirmed, distinguishing it from B-cell lymphomas.
Implications:
- This case underscores the rare but possible leukemic manifestation of Ki-1 positive large cell lymphoma.
- It emphasizes the need to include this diagnosis in the differential for patients with unexplained bone marrow or peripheral blood abnormalities.
- Accurate immunophenotypic analysis is crucial for correct diagnosis and management of such rare hematologic malignancies.
Abstract:
A 77 year-old woman with Ki-1 positive large cell lymphoma who presented with leukemic phase of the disease is reported. She noticed general fatigue and fever in 1992 and was found to have anemia and abnormal lymphoid cells in the peripheral blood. The bone marrow was diffusely involved by these cells, differentials of which included acute megakaryocytic leukemia, malignant histiocytosis, and anaplastic large cell lymphoma. Immunophenotypic analysis showed that they were positive for CD3, HLA-DR, CD25 and CD30, but negative for CD4, CD8, CD19, FVIII and GpIIb/IIIa indicating Ki-1 positive lymphoma with T-cell lineage. It may involve bone marrow, but leukemic phase of the disease is rarely seen. Therefore, it should be added to the differential diagnosis when large anaplastic or pleomorphic cells are seen in the bone marrow and/or peripheral blood.
