Pleural effusion as a rare sign of anaplastic large‐cell lymphoma in a COVID‐19 patient: A case report and literature review

Kamel, Omar Farouk; Rozen, Laurence; Lecomte, Sophie; Heimann, Pierre; Demulder, Anne

doi:10.1111/ijlh.13521

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…After reviewing lab investigations, the patient was found to have had a low glucose profile since admission that ranges between 1.7 and 5.1 mmol/L. Hence, the patient was labeled as a case of hypoglycemia for investigations with a differential diagnosis of [ 1 ] anaplastic lymphoma with infiltration to adrenal glands, [ 2 ] end-stage renal disease (ESRD) causing hypoglycemia, [ 3 ] or nutritional inadequacy.…”

Section: Case Reportmentioning

confidence: 99%

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Rare Presentation of Hypoglycemia in a Patient with Anaplastic Large-Cell Lymphoma

Aldahash

2021

Case Reports in Endocrinology

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Anaplastic large-cell lymphoma is a rare type of aggressive non-Hodgkin’s lymphoma, and arriving at a final diagnosis for this tumor is a challenge for the healthcare providers. Usually, it involves the lymph nodes and extranodal tissues such as the lungs, skin, and other soft tissues. Its presentation by extending into different organs such as the liver, lungs, bones, spleen, and thyroid is rare. Thus, involvement of other organs is very rare as we found in a 54-year-old male patient, a known case of hypertension and end-stage renal disease who was on hemodialysis, who presented to the emergency department with a history of generalized weakness and weight loss of about 20 kg for two months. The tumor cells are positive for CD45, CD30, CD15, MUMi, and Ki-67 (80%) and negative for CD20, PAX-5, CD79a, CD3, CD5, CD10, BCL6, BCL2, EMA, ALK-1, and CD138. The patient was hypoglycemic and hypercalcemic and was managed accordingly. The patient was evaluated, and the third assessment showed that hypoglycemia was resolved due to dexamethasone. The patient’s glucose storage was depleted most likely due to liver involvement plus poor general condition. It was asserted that the patient’s hypoglycemia could be related to his underlying malignancy. Also, the patient was advised to start tablet diazoxide 45 mg three times a day (3 mg/kg/day TID) in addition to levothyroxine tablet 50 mcg once a day. Tablet diazoxide was stopped, and nutritional support was recommended. This case reveals a rare systematic ALK-1-negative anaplastic large-cell lymphoma that involves multiple organs. The main learning point from this report is that these tumors can present atypically even in adults and can be ALK-1 negative, which is contrary to the typical systematic anaplastic large-cell lymphomas that are positive for ALK.

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Section: Case Reportmentioning

confidence: 99%

“…Lymphomas are the typical heterogeneous category of malignancies primarily of lymph nodes and are considered as a very rare type of aggressive non-Hodgkin's lymphomas [ 1 ]. More specifically, anaplastic large-cell lymphoma constitutes 5% of all cases of non-Hodgkin's lymphomas [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Rare Presentation of Hypoglycemia in a Patient with Anaplastic Large-Cell Lymphoma

Aldahash

2021

Case Reports in Endocrinology

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“…Anaplastic large cell lymphoma (ALCL), a unique non-Hodgkin T-cell lymphoma (NHL), is recognized under the group of large cell lymphoma with strong expression of CD30 positive pleomorphic cells. [ 1 2 3 4 5 ] Various molecular abnormalities have been detected in ALCL, such as t(2,5)(p23, q35), t(1;2)(q25;p23), t(2;3)(p23;q21), t(2;22)(p23;q11.2), and inv(2), which result in overexpression of anaplastic lymphoma kinase-1 (ALK-1) protein in immunohistochemistry (IHC). [ 5 6 ] Based on this ALK-1 protein expression and clinical data, it is broadly classified into two types, namely, systemic ALCL and primary cutaneous ALK-1 negative ALCL.…”

Section: Introductionmentioning

confidence: 99%

The Difficulties and Ease of Diagnosing Anaplastic Large Cell Lymphomas on Cytology

Sekar,

Gochhait,

Venkatesan

et al. 2024

Journal of Cytology

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Introduction and Objectives: Anaplastic large cell lymphoma (ALCL), a unique non-Hodgkin lymphoma (NHL), is a CD30-positive neoplasm of T-cell lineage. Its distinctive yet variable cytomorphology makes diagnosing fine needle aspiration cytology (FNAC) challenging. This study was undertaken to study the cytomorphology and the utility of immunocytochemical (ICC) stains on cytology in ALCL and to discuss their morphological differential diagnosis. Materials and Methods: The present study was conducted in the Department of Pathology of a tertiary care center. A retrospective review was done from January 2017 to July 2022, and all histopathologically and immunohistochemically (IHC) diagnosed cases of ALCL were taken and correlated with the cytological diagnosis. Results: Twenty-one cases of histopathology examination and IHC-proven cases of ALCL were retrieved from the departmental archives and reviewed. The ages ranged from 3 to 80 years (median age 28 years). Commonly noted cytomorphologic features included singly dispersed large pleomorphic cells, hallmark cells, and Reed-Sternberg-like cells. CD15, CD30, epithelial membrane antigen, and anaplastic lymphoma kinase-1 were some of the ICC stains used in this study. All 21 cases had cytology correlation. Fourteen cases had concordant cyto-histological correlation. Seven cases of histopathologically proven ALCL were reported as Hodgkin lymphoma (HL) in three, ALCL/anaplastic diffuse large B-cell lymphoma, HL/ALCL, poorly differentiated carcinoma, and NHL in one case each on cytology. Conclusion: ALCL has a reasonably distinct cytomorphologic appearance and ICC staining pattern, and a careful interpretation of both helps arrive at a reliable FNAC diagnosis.

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“…Anaplastic large cell lymphoma (ALCL) is a non‐Hodgkin lymphoma of T‐cell origin that is characterized by large pleomorphic lymphoid cells, often with horseshoe‐shaped nuclei, or hallmark cells, and with strong expression of CD30 1–3 . There are two categories of ALCL, systemic ALCL and primary cutaneous ALCL.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of anaplastic lymphoma kinase‐negative anaplastic large cell lymphoma on pleural fluid cytology

Greenland

Cook

et al. 2021

Diagnostic Cytopathology

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ALK‐negative anaplastic large cell lymphoma (ALCL) is an aggressive non‐Hodgkin T‐cell lymphoma. Compared to ALK‐positive ALCL, patients with ALK‐negative ALCL typically are older, present with nodal disease, and have lower survival rates. We report a unique presentation of ALK‐negative ALCL in a pleural fluid. Cell block preparation enabled both confirmation of the diagnosis via immunohistochemical staining and gene rearrangement testing for prognostic information.

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Pleural effusion as a rare sign of anaplastic large‐cell lymphoma in a COVID‐19 patient: A case report and literature review

Cited by 3 publications

References 12 publications

Rare Presentation of Hypoglycemia in a Patient with Anaplastic Large-Cell Lymphoma

Rare Presentation of Hypoglycemia in a Patient with Anaplastic Large-Cell Lymphoma

The Difficulties and Ease of Diagnosing Anaplastic Large Cell Lymphomas on Cytology

Diagnosis of anaplastic lymphoma kinase‐negative anaplastic large cell lymphoma on pleural fluid cytology

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