Journal Reading. 2006-05-05 Presented by Dr. 陳志榮. ALK-Positive Anaplastic Large Cell Lymphoma Mimicking Nodular Sclerosis Hodgkin ’ s Lymphoma Report of 10 Cases. Jose´ Vassallo, MD, PhD,*† Laurence Lamant, MD, PhD,* Laurence Brugieres, MD, PhD,‡
Presented by Dr.陳志榮
Jose´ Vassallo, MD, PhD,*† Laurence Lamant, MD, PhD,* Laurence Brugieres, MD, PhD,‡
Fanny Gaillard, MD, PhD,§ Elias Campo, MD, PhD,k Pierre Brousset, MD, PhD,*
and Georges Delsol, MD*
~~Am J Surg Pathol 2006;30:223–229
(1) biologically distinct entities.
(2) share some morphologic features.
(1) 10 cases: originally diagnosed as nodular sclerosis classic HL (NSHL) on conventional histopathological examination.
(1) first described as a distinct type of non
-Hodgkin lymphoma in 1985.
(2) characterized by the expression of the CD30
(3) large cell non-Hodgkin lymphomas, malignant
histiocytosis, and Hodgkin lymphoma (HL).
(4) approximately 3% to 5% of non-Hodgkin
lymphomas in adults and 10% to 30% in
(1) large cells with anaplastic morphologic features, expressing the CD30 antigen.
(2) a clear B-cell phenotype were included in the broad group of diffuse large B-cell lymphomas.
‘‘ALCL Hodgkin-like’’ or ‘‘Hodgkin related’’ to take into consideration the existence of cases with intermediate morphologic and phenotypical features between ALCL and HL.
confirmed that ALCL and HL are clinically and biologically different entities.
(1) HL with some features reminiscent of ALCL.
(2) the syncytial variant of nodular sclerosis => fibrosis is evident and neoplastic cells are present in large sheets.
=> confirmed by in situ hybridization technique using the EBER probe in 6 cases.
=>‘‘Hodgkin-related’’ or ‘‘Hodgkin’s-like’’ALCL
(1)Atypical cells were positive for ALK protein=>cytoplasmic, nuclear, and nucleolar staining pattern.
(2) 1 case suggests an association with the t(2;5) and the expression of NPM-ALK protein.
(1) about 75% of HL,
(2) may be occasionally found in rare cases of
=>these cases did not resemble HL, and the staining was restricted to the paranuclear area.
(1) observed in the majority of ALCL
=>3 cases only a proportion of malignant cell were positive.
(2) weak staining: about 5% of HL.
(3) such a positive staining in a given case should question the diagnosis of HL and require additional stainings, namely, ALK and T-cell markers.
the present series were positive for other T-cell markers (CD2, CD4, CD5, and/or CD7) and perforin.
(1) this antigen is expressed by the majority of ALCL and, before the availability of ALK1 antibody.
(2) CD43 was a useful marker in the differential diagnosis between ALCL and HL, because it is reported positive in only 5% of HL.
=> ALCL is not an EBV-associated disease
(1) immunohistochemistry (LMP1)
(2) in situ hybridization (EBER probe)