Anaplastic Large cell Lymphoma (ALCL): A Clinicopathologic study along with IHC profile.

Dr Abid Hussain; Dr T Roshni Paul; Dr Shantveer G Uppin; Dr Megha S Uppin; Dr Ashwani Tandon

Volume : VI, Issue : XI, November - 2017

Anaplastic Large cell Lymphoma (ALCL): A Clinicopathologic study along with IHC profile.

Dr Abid Hussain, Dr T Roshni Paul, Dr Shantveer G Uppin, Dr Megha S Uppin, Dr Ashwani Tandon

Abstract :

INTRODUCTION Anaplastic large cell lymphomas (ALCLs) are T–cell lymphomas characterized by large pleomorphic cells,and expression of CD 30. They can be ALK+ or ALK–.

OBJECTIVES: To study the clinicopathological profile of all diagnosed cases of ALCL, along with morphology and immunohistochemistry displaying different patterns of ALK staining.

STUDY DESIGN: All cases diagnosed as ALCL on histomorphology and CD 30+, ALK +ve or ALK –ve from 2001 to 2015 were studied. The histomorphology along with IHC were assessed. The clinical details were obtained from the patients files.

RESULTS: The 51 cases included (ALK+ =28; ALK– =13; ALK unavailable=10).The median age of presentation in ALK+ cases was 29.5years while 46.5 years in ALK–ve . There was a male predominance in both the subgroups with M: F (ALK+=2.1:1; ALK– =1.6:1). Most common presenting complaint was lymphadenopathy (90%), cervical lymphadenopathy being most frequent. Extranodal involvement was seen in 17 cases (33.3%) which included soft tissue (5), skin (4), and one case each from lung, appendix, colon and testis. Other symptoms included fever, loss of weight, and pleural effusion. The classic variant was the most common histological subtype (39), followed by Hodgkin–like (6), Lymphohistiocytic variant (3), small cell variant (2), composite variant(1). Of the 28 ALK+ ve cases, nuclear and cytoplasmic positivity was seen in 19 cases.

CONCLUSION:

ALK +ve ALCLs are more common in < 30yrs age group and ALK –ve ALCLs were more common in 30–60yrs age group. As the condition has a very varied histology and numerous close differentials include Hodgkins lymphoma, DLBCL, peripheral T cell lymphoma, Burkitts lymphoma, Langerhans cell histiocytosis and metastatic carcinoma . correlation of histomorphology along with an extensive panel of IHC is required to make the diagnosis.