ALK‐negative anaplastic large cell lymphoma with urinary bladder involvement diagnosed in urine cytology: A case report and literature review

Abstract

Anaplastic large cell lymphoma is an aggressive T-cell neoplasm. It rarely involves the urinary bladder, with just twelve cases reported thus far and only one being ALK-negative. Immunophenotyping (particularly for ALK) is mandatory, both for prognostic and therapeutic reasons. Herein, we report the case of a patient with an ALK-negative anaplastic large cell lymphoma involving the bladder which was diagnosed and fully characterized by immunocytochemistry in urine cytology. The patient underwent a cystoscopy and the urine sample disclosed tumor diathesis background and aggregates of atypical cells, with evidence of multinucleation and mitotic figures. Immunocytochemistry revealed strong membrane/Golgi positivity for CD30 and negativity for ALK. The patient was submitted to transurethral resection for therapeutic purposes, which confirmed the diagnosis. To the best of our knowledge, this represents only the third case of anaplastic large cell lymphoma with bladder involvement diagnosed in urine cytology and the very first with diagnostic findings allowing for immunophenotyping of the disease in a bladder wash. The present report reinforces the role of urine cytology as a suitable method for establishing an earlier diagnosis and characterization of the disease, avoiding submitting patients to invasive procedures like transurethral resections. Diagn. Cytopathol. 2017;45:354-358. © 2016 Wiley Periodicals, Inc.

Anaplastic Large Cell Lymphoma: Molecular Pathogenesis and Treatment

“…Extranodal sites are relatively common in the skin, soft tissue, liver, and lungs. As for rarely involved sites, they include the oropharynx, gastrointestinal tract, orbit, brain, and testes [ 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 ]. Skin lesions usually present as papules, nodules, or tumors.…”

ALK-Negative Anaplastic Large Cell Lymphoma: Current Concepts and Molecular Pathogenesis of a Heterogeneous Group of Large T-Cell Lymphomas

“…ALK- ALCL involves the lymph nodes in ~50% of cases whereas extranodal involvement is less frequent [ 14 , 15 ]. Relatively common extranodal sites of involvement include the skin (excluding pc-ALCL), soft tissue, the liver and the lungs, whereas rare sites of involvement include the oropharynx, the gastrointestinal tract, the orbit, the brain, and the testes [ 3 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Skin lesions may be solitary or multiple in the form of papules, nodules, or tumors.…”

Urinary tract involvement of mantle cell lymphoma diagnosed by urine cytology

“…Most primary lymphomas involving the urinary tract are large B‐cell type, but essentially any type of lymphoma may occur. Only seven cases of Non‐Hodgkin lymphoma diagnosed by a combination of urine cytology and ancillary studies (either flow cytometry or immunocytochemistry) performed on urine samples have been reported . Herein, we describe a case of mantle cell lymphoma (MCL) involving the urinary tract and diagnosed by urinary cytology, with confirmatory immunocytochemical stains.…”