Unusual clinical presentation of anaplastic large cell lymphoma

  • Fernando Peixoto Ferraz de Campos Divisão de Clínica Médica do Hospital Universitário da USP
  • Maria Claudia Nogueira Zerbini Departamento de Patologia da Faculdade de Medicina da USP
  • Aloisio Felipe-Silva Serviço de Anatomia Patológica do Hospital Universitário da USP
  • Angélica Braz Simões Serviço de Anatomia Patológica do Hospital Universitário da USP
  • Silvana Maria Lovisolo Serviço de Anatomia Patológica do Hospital Universitário da USP
  • Leonardo Gomes da Fonseca Instituto do Câncer de São Paulo
  • Lorena Laborda Divisão de Clínica Médica do Hospital Universitário da USP
Keywords: Lymphoma, Large-Cell, Anaplastic, Acquired Immunodeficiency Syndrome, Fever of Unknown Origin, Autopsy.

Abstract

Anaplastic large cell lymphoma (ALCL), a well-recognized entity, presents a varied clinical picture and epidemiological characteristics associated with the expression of the anaplastic lymphoma kinase (ALK) protein. When classic symptoms are present (weight loss, fever, and night sweats) and combine with enlarged and easily accessible peripheral lymph nodes, diagnosis is not that difficult. But when the clinical presentation is nonspecific, a tough diagnostic task is required. HIV infection is highly associated with neoplastic disorders—mainly with those of hematological origin. However, ALCL is exceptionally associated with HIV infection, and the few reported cases are ALK– ALCL. The authors report two cases of ALK+ ALCL with the unusual clinical presentation: one is associated with the HIV infection and the other presents as a fever of unknown origin (FUO) without peripheral lymphadenopathy. The latter was autopsied and was characterized by nodal and extra nodal involvement. The authors call attention to the plurality of clinical presentation of this group of lymphomas, and the early indication of bone marrow examination in cases of an FUO with elevated hepatic enzymes and lactic dehydrogenase.

Downloads

Download data is not yet available.
Published
2014-03-31
How to Cite
Campos, F., Zerbini, M., Felipe-Silva, A., Simões, A., Lovisolo, S., Fonseca, L., & Laborda, L. (2014). Unusual clinical presentation of anaplastic large cell lymphoma. Autopsy and Case Reports, 4(1), 21-27. https://doi.org/10.4322/acr.%y.81207
Section
Article / Autopsy Case Report