ALK-positive large b-cell lymphoma

Zenggang Pan, Shimin Hu, Min Li, Yi Zhou, Young S. Kim, Vishnu Reddy, Jennifer N Sanmann, Lynette M Smith, Mingyi Chen, Zifen Gao, Huan You Wang, Ji Yuan

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK + LBCL) is a rare, aggressive subtype of diffuse large B-cell lymphoma with characteristic ALK rearrangements. Diagnosis of ALK + LBCL can be challenging because of its rarity, unique morphologic characteristics, and unusual immunophenotypic features, which significantly overlap with other hematologic and nonhematologic neoplasms. The purpose of this study is to further explore the clinicopathologic features of ALK + LBCL to ensure the awareness and accurate diagnosis of this entity. We retrospectively reviewed the data from 26 cases in our institutions and additional 108 cases from the literature. ALK + LBCL typically occurred in the lymph nodes of young and middle-aged, immunocompetent patients. The medium age was 35 years with a male to female ratio of 3.5:1. Vast majority of cases showed immunoblastic and/or plasmablastic morphology. All cases expressed ALK protein with a cytoplasmic granular pattern in most of them. Common B-cell markers (CD20, CD79a, and PAX5) were typically negative, but the tumor cells mostly expressed 2 B-cell transcriptional factors, BOB1 and OCT2. The 5-year overall survival (OS) was 34%, and the median survival was 1.83 years. In patients with stage III/IV disease, the 5-year OS was only 8%. Moreover, patients below 35 years of age had a significantly better OS than those aged 35 years or above.

Original languageEnglish (US)
Pages (from-to)25-38
Number of pages14
JournalAmerican Journal of Surgical Pathology
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Lymphoma
Survival
B-Lymphocytes
Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
Hematologic Neoplasms
Lymph Nodes
Neoplasms
Proteins

Keywords

  • ALK
  • CLTC/ALK
  • anaplastic lymphoma kinase
  • large B-cell lymphoma
  • t(2;17)

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

ALK-positive large b-cell lymphoma. / Pan, Zenggang; Hu, Shimin; Li, Min; Zhou, Yi; Kim, Young S.; Reddy, Vishnu; Sanmann, Jennifer N; Smith, Lynette M; Chen, Mingyi; Gao, Zifen; Wang, Huan You; Yuan, Ji.

In: American Journal of Surgical Pathology, Vol. 41, No. 1, 01.01.2017, p. 25-38.

Research output: Contribution to journalReview article

Pan, Z, Hu, S, Li, M, Zhou, Y, Kim, YS, Reddy, V, Sanmann, JN, Smith, LM, Chen, M, Gao, Z, Wang, HY & Yuan, J 2017, 'ALK-positive large b-cell lymphoma', American Journal of Surgical Pathology, vol. 41, no. 1, pp. 25-38. https://doi.org/10.1097/PAS.0000000000000753
Pan Z, Hu S, Li M, Zhou Y, Kim YS, Reddy V et al. ALK-positive large b-cell lymphoma. American Journal of Surgical Pathology. 2017 Jan 1;41(1):25-38. https://doi.org/10.1097/PAS.0000000000000753
Pan, Zenggang ; Hu, Shimin ; Li, Min ; Zhou, Yi ; Kim, Young S. ; Reddy, Vishnu ; Sanmann, Jennifer N ; Smith, Lynette M ; Chen, Mingyi ; Gao, Zifen ; Wang, Huan You ; Yuan, Ji. / ALK-positive large b-cell lymphoma. In: American Journal of Surgical Pathology. 2017 ; Vol. 41, No. 1. pp. 25-38.
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AU - Zhou, Yi

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AU - Sanmann, Jennifer N

AU - Smith, Lynette M

AU - Chen, Mingyi

AU - Gao, Zifen

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AB - Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK + LBCL) is a rare, aggressive subtype of diffuse large B-cell lymphoma with characteristic ALK rearrangements. Diagnosis of ALK + LBCL can be challenging because of its rarity, unique morphologic characteristics, and unusual immunophenotypic features, which significantly overlap with other hematologic and nonhematologic neoplasms. The purpose of this study is to further explore the clinicopathologic features of ALK + LBCL to ensure the awareness and accurate diagnosis of this entity. We retrospectively reviewed the data from 26 cases in our institutions and additional 108 cases from the literature. ALK + LBCL typically occurred in the lymph nodes of young and middle-aged, immunocompetent patients. The medium age was 35 years with a male to female ratio of 3.5:1. Vast majority of cases showed immunoblastic and/or plasmablastic morphology. All cases expressed ALK protein with a cytoplasmic granular pattern in most of them. Common B-cell markers (CD20, CD79a, and PAX5) were typically negative, but the tumor cells mostly expressed 2 B-cell transcriptional factors, BOB1 and OCT2. The 5-year overall survival (OS) was 34%, and the median survival was 1.83 years. In patients with stage III/IV disease, the 5-year OS was only 8%. Moreover, patients below 35 years of age had a significantly better OS than those aged 35 years or above.

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