Primary Anaplastic Large Cell Lymphoma of the Lung: A Clinicopathologic Study of Five Patients

• Published in: Modern pathology 2000-12, Vol.13 (12), p.1285-1292
• Main Authors: Rush, Walter L, Andriko, Jo Ann W, Taubenberger, Jeffrey K, Nelson, Ann M, Abbondanzo, Susan L, Travis, William D, Koss, Michael N
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anaplastic large cell lymphoma; Epstein-Barr virus; Fatal Outcome; Female; Gene Rearrangement; HIV Infections - complications; Human Immunodeficiency Virus; Humans; Immunohistochemistry; Immunophenotyping; Laboratory Medicine; Lung; Lung Neoplasms - genetics; Lung Neoplasms - immunology; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Lymphoma, Large B-Cell, Diffuse - etiology; Lymphoma, Large B-Cell, Diffuse - genetics; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local; original-article; Pathology; Survival Analysis
• ISSN: 0893-3952; 1530-0285
• DOI: 10.1038/modpathol.3880235

Primary anaplastic large-cell lymphoma is a rare malignancy in the lung. Anaplastic large-cell lymphoma characteristically involves the lymph nodes or skin, with few reports from other sites. We studied the clinical and pathologic features of five cases of anaplastic large-cell lymphoma limited to the lungs. The patients were three women and two men aged 27 to 66 years (mean, 44.6 y) The tumors ranged in size from 1.1 to 5 cm. All patients were CD 30 (Ki-1) positive and CD 15 (LeuM-1) negative. Epithelial membrane antigen immunoreactivity was seen in two patients. Epstein-Barr virus was not detected by immunohistochemistry (four patients tested) or by polymerase chain reaction studies (three patients tested). The immunophenotypes were T cell (n = 3) and null (n = 2). Gene rearrangement studies supported the immunophenotypic findings. One patient who had underlying HIV infection died of infectious complications. One patient died at 6 months. Two patients developed recurrent disease and are alive after 42 and 51 months of follow-up. The remaining patient is alive at 8 years of follow-up without evidence of disease. ALCL can mimic metastatic or primary carcinoma and should be considered in the differential diagnosis of large cell neoplasms of the lung.