Clinicopathological features of 15 cases of anaplastic large cell lymphoma with small cell variant
10.13315/j.cnki.cjcep.2025.02.010
- VernacularTitle:小细胞变异型间变大细胞淋巴瘤15例临床病理特征
- Author:
Wenjing CUI
1
;
Peizhen HU
1
;
Yingmei WANG
1
;
Shirong MA
1
Author Information
1. 空军军医大学第一附属医院病理科,西安 710032
- Publication Type:Journal Article
- Keywords:
lymphoma;
anaplastic larges-cell lymphoma;
small cell variant;
immunohistochemistry
- From:
Chinese Journal of Clinical and Experimental Pathology
2025;41(2):198-202
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the clinicopathological features and differential diagnosis of anaplastic large-cell lymphoma(ALCL)with the small cell variant.Methods The clinical data of 15 cases of small cell variant of ALCL were retrospectively analyzed.Hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization,TCR and IgG rearrangement were performed.The clinicopathological features,prognosis and differential diagnosis were summarized with review of the literature.Results Among the 15 cases of small cell ALCL,5 were females and 10 were males,with a male-to-female ratio of 2:1.Among the 15 cases of small cell ALCL,14 were systemic ALCL[(12 cases of ALK+),and the age range was 5-63 years old(median age 20 years);There were 2 cases of ALK(-),aged more than 60 years],and 1 case of ALCL of primary cutaneous ALK(-).Microscopic features were dominated by small to medium-sized tumor cells,with irregular nuclear membranes,inconspicuous nucleoli,and a lack of or few iconic large cells.Immunohistochemically:3 cases were ALK-negative and 12 cases were ALK-positive.Tumor cells were CD30 positive in 14/15 cases,CD3 positive in 7/15 cases,CD2 positive in 2/6 cases,CD4 positive in 5/11 cases,CD5 positive in 2/8 cases,CD7 positive in 4/6 cases,CD8 positive in 1/8 cases,TIA-1 positive in 7/7 cases,Granzyme B positive in 4/6 cases and EMA positive in 6/7 cases.CD20 was negative in all cases.Immuno-globulin IgG and TCR gene rearrangement were negative in case 4 and case 11.Case 13 was positive for TCR rear-rangement and negative for immunoglobulin IgG.Twelve of the 15 patients were followed up for 0.7-165 months(me-dian,7 months),3 patients were lost to follow-up and 7 patients died.Conclusion Small cell variant ALCL is easily misdiagnosed as an inflammatory or infectious disease.A group of antibodies,including CD30 and ALK,should be routinely used in routine work,especially in young patients with systemic symptoms and leukemia manifestations or in small biopsies,to reduce misdiagnosis and missed diagnosis.
