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:*[[Anaplastic large cell lymphoma, ALK positive]]
:*[[Anaplastic large cell lymphoma, ALK positive]]
:*[[Anaplastic large cell lymphoma, ALK negative]]
:*[[Anaplastic large cell lymphoma, ALK negative]]
* Based on clinical presentations, anaplastic large cell lymphoma may be classified into either<ref name= canadian.cancer>Anaplastic large cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/anaplastic-large-cell-lymphoma/?region=on Accessed on October 7, 2015</ref>  
* Based on clinical presentations, anaplastic large cell lymphoma may be classified into 2 subtypes:<ref name= canadian.cancer>Anaplastic large cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/anaplastic-large-cell-lymphoma/?region=on Accessed on October 7, 2015</ref>  
:* Primary cutaneous anaplastic large cell lymphoma
:* Primary cutaneous anaplastic large cell lymphoma
:* Primary systemic anaplastic large cell lymphoma
:* Primary systemic anaplastic large cell lymphoma

Revision as of 13:03, 13 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Anaplastic large cell lymphoma may be classified into several subtypes based on clinical presentation and histology.

Classification

  • Anaplastic large cell lymphoma (peripheral T-cell lymphoma Non-Hodgkin Lymphoma) may be classified into 2 subtypes:
  • Based on clinical presentations, anaplastic large cell lymphoma may be classified into 2 subtypes:[1]
  • Primary cutaneous anaplastic large cell lymphoma
  • Primary systemic anaplastic large cell lymphoma
  • Based on histology, anaplastic large cell lymphoma may be classified into 3 subtypes:
  • Classical Variants
  • Atypical Variants
  • Rare Variants
Classification based on the clinical presentation[1]
Name Description
Primary cutaneous anaplastic large cell lymphoma
  • Confined to the skin
  • Usually have a single lump or tumor in the skin
  • May also spread to lymph nodes in the area
  • Associated with a rare skin condition called lymphomatoid papulosis
  • Less aggressive than primary systemic anaplastic large cell lymphoma
  • Occasionally individuals have a spontaneous remission
  • Have a fairly good prognosis
Primary systemic anaplastic large cell lymphoma
  • Usually involves the lymph nodes
  • Can also occur in organs or tissues other than the lymph nodes (extranodal sites), including:
  • Lungs, liver, bone marrow, bone, gastrointestinal tract, skin, and soft tissue
  • Most individuals have advanced stage (stage III or IV) disease when they are diagnosed
  • Usually a fast-growing (aggressive) lymphoma
Histologic Classification [2][3]
Name Description
Classical Variants
Common pattern
  • ALK positive anaplastic large cell lymphoma
  • Most common morphological variant (75%)[4]
  • In large cells, nucleoli tend to be more prominent
  • The cytoplasm may be either basophilic or eosinophilic and the cell might have many nuclei with dispersed or clumped chromatin
  • Given that the lymphomatous cells grow in the lymph node's sinuses, this variant may resemble a metastatic tumor
Atypical Variants
Small cell
  • ALK positive anaplastic large cell lymphoma
  • Cells have nuclear irregularity and perivascular/intravascular distribution[5]
  • Occasionally, lymphomatous cells have a pale cytoplasm with a central nucleus, described as "fried egg cell"[3]
Lymphohistiocytic
  • ALK positive anaplastic large cell lymphoma
  • Histiocytes have an acidophilic cytoplasm and a perinuclear clear area, with an eccentric nuclei and condensed chromatin[6]
  • Lymphomatous cells cluster around the perivascular area as demonstrated by immunostaining with CD30 and ALK antibodies[3]
Giant cell
  • ALK positive anaplastic large cell lymphoma
Hodgkin's like
  • The morphological characteristics of this pattern are similar to the nodular sclerosis variant of Hodgkin's lymphoma[7]
  • This pattern is predominately more common among female
  • There are two immunophenotype:[7]
    • Positive: CD30, ALK, epithelial membrane antigen (EMA), CD43 (only 66% of the times), and perforin
    • Negative: CD15, CD20, Pax5/BSAP, and EBV
Rare Variants
Sarcomatoid
  • ALK positive anaplastic large cell lymphoma


References

  1. ↑ 1.0 1.1 Anaplastic large cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/anaplastic-large-cell-lymphoma/?region=on Accessed on October 7, 2015
  2. ↑ The anaplastic lymphoma kinase in the pathogenesis of cancer. http://go.galegroup.com/ps/retrieve.dosgHitCountType=None&sort=RELEVANCE&inPS=true&prodId=HRCA&userGroupName=mlin_b_bethidmc&tabID=T002&searchId=R1&resultListType=RESULT_LIST&contentSegment=&searchType=AdvancedSearchForm&currentPosition=1&contentSet=GALE%7CA188154738&&docId=GALE Accessed on October 8, 2015
  3. ↑ 3.0 3.1 3.2 Swerdlow, Steven (2008). WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon, France: International Agency for Research on Cancer. ISBN 9789283224310.
  4. ↑ Falini B, Bigerna B, Fizzotti M, Pulford K, Pileri SA, Delsol G; et al. (1998). "ALK expression defines a distinct group of T/null lymphomas ("ALK lymphomas") with a wide morphological spectrum". Am J Pathol. 153 (3): 875–86. doi:10.1016/S0002-9440(10)65629-5. PMC 1853018. PMID 9736036.
  5. ↑ Kinney MC, Collins RD, Greer JP, Whitlock JA, Sioutos N, Kadin ME (1993). "A small-cell-predominant variant of primary Ki-1 (CD30)+ T-cell lymphoma". Am J Surg Pathol. 17 (9): 859–68. PMID 8394652.
  6. ↑ "Frequent Expression ofthe NPM-ALK Chimeric Fusion Protein inAnaplastic Large-Cell Lymphoma, Lympho-Histiocytic Type" (PDF).
  7. ↑ 7.0 7.1 Vassallo J, Lamant L, Brugieres L, Gaillard F, Campo E, Brousset P; et al. (2006). "ALK-positive anaplastic large cell lymphoma mimicking nodular sclerosis Hodgkin's lymphoma: report of 10 cases". Am J Surg Pathol. 30 (2): 223–9. PMID 16434897.

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