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Table of Contents
Vol. 43, No. 6, 2007
Issue release date: November 2007
Pediatr Neurosurg 2007;43:516–521
(DOI:10.1159/000108799)

Primary Cerebral ALK-1-Positive Anaplastic Large Cell Lymphoma in a Child

Case Report and Literature Review

Karikari I.O. · Thomas K.K. · Lagoo A. · Cummings T.J. · George T.M.
aPediatric Neurosurgery Service and bDepartment of Pathology, Duke University Medical Center, Durham, N.C., cChildren’s Hospital of Austin, Austin, Tex., USA

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Abstract

A 4-year-old African American male was referred to the Pediatric Neurosurgery Service for evaluation of new onset seizures and worsening mental status. An MRI of the brain revealed a pineal region mass with diffuse leptomeningeal enhancement and compression of the basilar cisterns. A biopsy of the brain revealed histologic and immunophenotypic findings characteristic of ALK-1+ anaplastic large cell lymphoma (ALCL). ALCL rarely occurs in the central nervous system and poses a significant diagnostic challenge often leading to a delay in the initiation of appropriate treatment. We describe a case of a rapidly deteriorating clinical course in a child with central nervous system ALCL and review the current literature on ALCL occurring in the central nervous system.



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References

  1. Delsol G, Ralfkiaer E, Sein H, et al: Anaplastic large cell lymphoma; in Jaffe ES, Harris NL, Stein H, Vardiman JW (eds): Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. World Health Organization Classification of Tumours. Lyon, IARC Press, 2001, pp 230–235.
  2. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC, et al: A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 1994;84:1361–1392.
  3. Benharroch D, Meguerian-Bedoyan Z, Lamant L, Amin C, Brugieres L, Terrier-Lacombe MJ, Haralambieva E, Pulford K, Pileri S, Morris SW, Mason DY, Delsol G: ALK-positive lymphoma: a single disease with a broad spectrum of morphology. Blood 1998;91:2076–2084.
  4. Chott A, Kaserer K, Augustin I, Vesely M, Heinz R, Oehlinger W, Hanak H, Radaszkiewicz T: Ki-1-positive large cell lymphoma: a clinicopathologic study of 41 cases. Am J Surg Pathol 1990;14:439–448.
  5. Falini B, Pileri S, Zinzani PL, Carbone A, Zagonel V, Wolf-Peeters C, Verhoef G, Menestrina F, Todeschini G, Paulli M, Lazzarino M, et al: ALK+ lymphoma: clinico-pathological findings and outcome. Blood 1999;93:2697–2706.
  6. Penny RJ, Blaustein JC, Longtine JA, Pinkus GS: Ki-1-positive large cell lymphomas, a heterogenous group of neoplasms: morphologic, immunophenotypic, genotypic, and clinical features of 24 cases. Cancer 1991;68:362–373.
  7. Abdulkader I, Cameselle-Teijeiro J, Fraga M, Rodriguez-Nunez A, Allut AG, Forteza J: Primary anaplastic large cell lymphoma of the central nervous system. Hum Pathol 1999;30:978–981.
  8. Buxton N, Punt J, Hewitt M: Primary Ki-1-positive T-cell lymphoma of the brain in a child. Pediatr Neurosurg 1998;29:250–252.
  9. Chuang SS, Huang W, Lin CN, Chio CC, Tsai TC, Li CY, Shen CH: Primary cerebral anaplastic large cell lymphoma containing abundant reactive histiocytes and eosinophils: a case report and literature review. Pathol Res Pract 2001;197:647–652.
  10. Feldges A, Gerhard L, Reinhardt V, Budach V: Primary cerebral anaplastic T-cell-lymphoma (type Ki-1): review and case report. Clin Neuropathol 1992;11:55–59.
  11. George DH, Scheithauer BW, Aker FV, Kurtin PJ, Burger PC, Cameselle-Teijeiro J, McLendon RE, Parisi JE, Paulus W, Roggendorf W, Sotelo C: Primary anaplastic large cell lymphoma of the central nervous system: prognostic effect of ALK-1 expression. Am J Surg Pathol 2003;27:487–493.
  12. Goldbrunner R, Warmuth-Metz M, Tonn JC, Vince GH, Roosen K: Primary Ki-1-positive T-cell lymphoma of the brain – an aggressive subtype of lymphoma: case report and review of the literature. Surg Neurol 1996;46:37–41.
  13. Havlioglu N, Manepalli A, Galindo L, Sotelo-Avila C, Grosso L: Primary Ki-1 (anaplastic large cell) lymphoma of the brain and spinal cord. Am J Clin Pathol 1995;103:496–499.
  14. Paulus W, Ott MM, Strik H, Keil V, Muller-Hermelink HK: Large cell anaplastic (KI-1) brain lymphoma of T-cell genotype. Hum Pathol 1994;25:1253–1256.
  15. Ponzoni M, Terreni MR, Ciceri F, Ferreri AJ, Gerevini S, Anzalone N, Valle M, Pizzolito S, Arrigoni G: Primary brain CD30+ ALK1+ anaplastic large cell lymphoma (‘ALKoma’): the first case with a combination of ‘not common’ variants. Ann Oncol 2002;13:1827–1832.
  16. Stein H, Mason DY, Gerdes J, O’Connor N, Wainscoat J, Pallesen G, Gatter K, Falini B, Delsol G, Lemke H, et al: The expression of the Hodgkin’s disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells. Blood 1985;66:848–858.
  17. Bischof D, Pulford K, Mason DY, Morris SW: Role of the nucleophosmin (NPM) portion of the non-Hodgkin’s lymphoma-associated NPM-anaplastic lymphoma kinase fusion protein in oncogenesis. Mol Cell Biol 1997;17:2312–2325.
  18. Bai RY, Dieter P, Peschel C, Morris SW, Duyster J: Nucleophosmin-anaplastic lymphoma kinase of large-cell anaplastic lymphoma is a constitutively active tyrosine kinase that utilizes phospholipase C-gamma to mediate its mitogenicity. Mol Cell Biol 1998;18:6951–6961.
  19. Cataldo KA, Jalal SM, Law ME, Ansell SM, Inwards DJ, Fine M, Arber DA, Pulford KA, Strickler JG: Detection of t(2;5) in anaplastic large cell lymphoma: comparison of immunohistochemical studies, FISH, and RT-PCR in paraffin-embedded tissue. Am J Surg Pathol 1999;23:1386–1392.
  20. Nakamura S, Shiota M, Nakagawa A, Yatabe Y, Kojima M, Motoori T, Suzuki R, Kagami Y, Ogura M, Morishima Y, Mizoguchi Y, Okamoto M, Seto M, Koshikawa T, Mori S, Suchi T: Anaplastic large cell lymphoma: a distinct molecular pathologic entity: a reappraisal with special reference to p80(NPM/ALK) expression. Am J Surg Pathol 1997;21:1420–1432.
  21. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H: Pathology with clinical correlations of primary central nervous system non-Hodgkin’s lymphoma. The Massachusetts General Hospital experience 1958–1989. Cancer 1994;74:1383–1397.
  22. Paulus W, Jellinger K, Morgello S, et al: Malignant lymphomas; in Kleihues P, Cavenee WK (eds): Pathology and Genetics of Tumors of the Nervous System: World Health Organization Classification of Tumors. Lyon, IARC Press, 2000, pp 198–203.
  23. Ferreri AJ, Reni M, Pasini F, Calderoni A, Tirelli U, Pivnik A, Aondio GM, Ferrarese F, Gomez H, Ponzoni M, Borisch B, Berger F, Chassagne C, Iuzzolino P, Carbone A, Weis J, Pedrinis E, Motta T, Jouvet A, Barbui T, Cavalli F, Blay JY: A multicenter study of treatment of primary CNS lymphoma. Neurology 2002;58:1513–1520.
  24. Shiota M, Nakamura S, Ichinohasama R, Abe M, Akagi T, Takeshita M, Mori N, Fujimoto J, Miyauchi J, Mikata A, Nanba K, Takami T, Yamabe H, Takano Y, Izumo T, Nagatani T, Mohri N, Nasu K, Satoh H, Katano H, Fujimoto J, Yamamoto T, Mori S: Anaplastic large cell lymphomas expressing the novel chimeric protein p80NPM/ALK: a distinct clinicopathologic entity. Blood 1995;86:1954–1960.
  25. Su LD, Schnitzer B, Ross CW, Vasef M, Mori S, Shiota M, Mason DY, Pulford K, Headington JT, Singleton TP: The t(2;5)-associated p80 NPM/ALK fusion protein in nodal and cutaneous CD30+ lymphoproliferative disorders. J Cutan Pathol 1997;24:597–603.
  26. Beylot-Barry M, Groppi A, Vergier B, Pulford K, Merlio JP: Characterization of t(2;5) reciprocal transcripts and genomic breakpoints in CD30+ cutaneous lymphoproliferations. Blood 1998;91:4668–4676.
  27. Wood GS, Hardman DL, Boni R, Dummer R, Kim YH, Smoller BR, Takeshita M, Kikuchi M, Burg G: Lack of the t(2;5) or other mutations resulting in expression of anaplastic lymphoma kinase catalytic domain in CD30+ primary cutaneous lymphoproliferative disorders and Hodgkin’s disease. Blood 1996;88:1765–1770.
  28. Non-Hodgkin’s Lymphoma Classification Project: A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. Blood 1997;89:3909–3918.

    External Resources

  29. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, Guy G, Lapierre F: Primary intracerebral malignant lymphoma: report of 248 cases. J Neurosurg 2000;92:261–266.


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