Pediatric case of anaplastic lymphoma kinase‐positive anaplastic large cell lymphoma forming a solitary skin tumor on the forearm

Tokuyama, Michio; Kurashige, Yuta; Ota, Tami; Manabe, Yasuaki; Yamaoka, Hanako; Ikoma, Norihiro; Fukumura, Akiko; Miyashita, Michie; Otsubo, Kenji; Morimoto, Takahiro; Mochizuki, Hiroyasu; Nakano, Natsuko; Nakamura, Naoya; Ozawa, A.; Mabuchi, Tomotaka

doi:10.1111/1346-8138.13688

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…Tokuyama et al (11) presented a 5-year-old girl with ALK positive ALCL forming a solitary skin tumor on the forearm. She was treated by ALCL-99 trial protocol (combination of dexamethasone, cyclophosphamide, methotrexate, ifosfamide, cytarabine, etoposide and doxorubicin) leading to marked improvement although there was no evidence of systemic dissemination.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of breast masses in childhood: ALK positive anaplastic large cell lymphoma

et al. 2021

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Objective: Non-Hodgkin's lymphomas (NHLs) are the result of malign proliferation of lymphoid cells. According to the morphological, immunological and genetic characteristics of childhood NHLs, they are classified as Burkitt lymphoma (BL), Lymphoblastic lymphoma (LL), diffuse large B-cell lymphoma (DLBCL) and anaplastic large cell lymphoma (ALCL). Anaplastic large cell lymphoma is a distinct form of non-Hodgkin lymphoma (NHL) which accounts for 15% of all childhood lymphomas. We report a girl presented with a breast mass and diagnosed with systemic ALCL. Case: A 14-year-old girl was referred to our hospital with without a painless mass in the left breast. Physical examination, it was seen two painless mass was found in the left breast. Also, a 2x2 cm, painless lymphadenopathy was found in the left axilla. She had no systemic symptoms In laboratory tests; hemoglobin, white blood cell count, platelet count, liver and kidney function tests, LDH, and uric acid levels were normal. In the imaging and metastasis screenings made to the patient; ultrasound and computed tomography (CT) showed two masses breast region. A large number of lymphadenopathies were detected in the left axillary, which surrounded the paraaortic, the paracaval, and the celiac truncus. She was found to have a hypermetabolic two masses in the breast (SUVmax=33.05) and lymphadenopathies (SUVmax=27.04) in the left axillary, paraaortic, the paracaval, and the celiac truncus on Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan. Excisional biopsy of the tumor mass in the breast was done and immunohistochemical analysis showed CD30 and anaplastic lymphoma kinase (ALK) positive ALCL. The patient was diagnosed with stage III anaplastic large cell lymphoma with systemic involvement and she began chemotherapeutic treatment, according to the NHL BFM 1995 protocol. Bone marrow aspirate was normal, and no malignancy was observed in the cerebrospinal fluid. After V-phase, AM block, and BM block treatments evaluation were performed with ¹⁸F-FDG PET/CT according to protocol. In ¹⁸F-FDG PET/CT, it was seen that the lymph nodes in the abdominal and the small mass in the breast were completely retracted, and another lymph nodes had no detected. These results showed that the response to the treatment was complete and the patient's chemotherapy was completed by continuing with the protocol. ¹⁸F-FDG PET/CT taken after the completion of chemotherapy revealed no evidence of mass or lymph node. The patient's controls continue smoothly. Conclusions: Anaplastic large cell lymphoma should also be considered in the differential diagnosis of children presented with a breast mass. Treatment procedures should be planned according to the involvement site and spread of the disease.

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Section: Discussionmentioning

confidence: 99%

A rare cause of breast masses in childhood: ALK positive anaplastic large cell lymphoma

et al. 2021

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“…Following the diagnosis of ALK‐positive pcALCL in the presented case, and in a pediatric patient that had been recently reported by our institution, we searched the literature for ALK‐positive pcALCL cases to better characterize the course and prognosis of this rare variant. Including our cases, we identified nine pediatric patients and 12 adults who were diagnosed with ALK‐positive pcALCL (Table ). Complete staging was performed in 15 of 21 cases.…”

Section: Discussionmentioning

confidence: 99%

“…pcALCL is generally found to be ALK-negative, and ALK expression in skin lesions of ALCL evokes high suspicion for secondary skin involvement by sALCL. 1 Recently, ALKpositive pcALCL has been reported in both children and adults [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] with heterogenous courses described.…”

Section: Introductionmentioning

confidence: 99%

ALK‐positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature

et al. 2017

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Anaplastic large cell lymphoma (ALCL) limited to the skin is a distinct disease that is designated primary cutaneous ALCL (pcALCL). It has an indolent course with a significantly better prognosis compared to systemic ALCL (sALCL). Anaplastic lymphoma kinase (ALK) expression in lesions of cutaneous ALCL is classically considered to be a marker for skin involvement by sALCL. However, recent reports of patients with ALK-positive pcALCL challenge this concept and raise prognostic and therapeutic dilemmas. Herein, we report a case of ALK-positive pcALCL in a 45-year-old woman who was treated with local radiotherapy. We review previously reported cases in the literature to better characterize this rare variant. Overall, the rates of cutaneous recurrence, systemic dissemination, and disease-related mortality in ALK-positive pcALCL do not differ from those previously reported in pcALCL. ALK-positive pcALCL is diagnosed at younger age and has a better disease course in children compared to adults with lower incidences of skin recurrence and progression to systemic disease. We conclude that ALK-positivity in cutaneous ALCL does not necessarily imply systemic disease. ALK-positive pcALCL has an excellent prognosis and should be treated by excision and/or radiotherapy. However, patients must remain under close long-term follow-up as recurrence and progression to systemic disease may occur.

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“…Among them, there are 10 cases, including ours, whose tumor cells expressed ALK only in the cytoplasm (Table 1). The average age was 38.3 years old and females were dominant 2–9 . Skin lesions are mostly seen in the extremities.…”

Section: Literature Review Of Cytoplasmic Alk‐positive Alcl Initially...mentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9] Skin lesions are mostly seen in the extremities. Half of the cases (five cases) developed extracutaneous lesions.…”

mentioning

confidence: 99%

Detection of TRAF1‐ALK fusion in skin lesions of systemic ALK+ anaplastic large cell lymphoma initially involving the skin and the draining lymph node

Norimatsu,

Akatsuka,

Matsuoka

et al. 2023

The Journal of Dermatology

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A case of cytoplasmic anaplastic lymphoma kinase (ALK)‐positive anaplastic large cell lymphoma (ALCL) initially involving the skin in a 44‐year‐old Japanese female is reported. The patient had a hemorrhagic erythematous tumor on the right thigh without any systemic symptoms. Pathology showed diffuse infiltration of CD30‐positive anaplastic large cells positive for epithelial membrane antigen and cytoplasmic ALK. The right inguinal lymph node showed infiltration of tumor cells in the marginal sinus. Only 2 weeks after radiation therapy, the patient developed multiple subcutaneous nodules and lung involvement. Even after subsequent multichemotherapy sessions, cutaneous recurrence occurred. Literature review of cytoplasmic ALK‐positive ALCL initially involving in the skin revealed that skin lesions were mostly seen in the extremities and that half of the cases developed extracutaneous lesions. Radiation and chemotherapy were effective for most cases. Inverse RT‐PCR identified a tumor necrosis factor receptor‐associated factor (TRAF)1‐ALK fusion in our case. Most reported cases with this translocation experienced repeated changes in chemotherapy, suggesting poorer prognosis. Although ALK‐positive ALCL generally responds well to chemotherapy, the presence of a TRAF1‐ALK fusion may suggest resistance to treatment. Detection of fusion partners of ALK is important for predicting clinical courses and deciding treatment options.

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Pediatric case of anaplastic lymphoma kinase‐positive anaplastic large cell lymphoma forming a solitary skin tumor on the forearm

Cited by 5 publications

References 10 publications

A rare cause of breast masses in childhood: ALK positive anaplastic large cell lymphoma

A rare cause of breast masses in childhood: ALK positive anaplastic large cell lymphoma

ALK‐positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature

Detection of TRAF1‐ALK fusion in skin lesions of systemic ALK+ anaplastic large cell lymphoma initially involving the skin and the draining lymph node

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