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Fine‐needle aspiration biopsy of anaplastic large cell lymphoma, small cell variant with prominent plasmacytoid features: Case report
Author(s) -
Gatter Ken M.,
Rader Anne,
Braziel Rita M.
Publication year - 2002
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.10056
Subject(s) - anaplastic large cell lymphoma , medicine , anaplastic lymphoma kinase , pathology , fine needle aspiration , lymphoma , biopsy , malignancy , differential diagnosis , immunophenotyping , cytopathology , lymph node , immunohistochemistry , cytology , antigen , immunology , malignant pleural effusion , lung cancer
Anaplastic large cell lymphoma (ALCL), according to the new WHO classification, is a diagnosis limited to T/NK cell lymphomas. We present a case that demonstrates a new morphologic variant of ALCL with significant possible pitfalls for the cytopathologist. A fine‐needle aspiration biopsy of a cervical lymph node showed a cellular aspiration comprised of medium‐sized plasmacytoid cells in a discohesive and focally loosely cohesive pattern. The cytologic diagnosis confirmed the presence of malignancy and noted the prominent plasmacytoid features. An accompanying comment favored melanoma and included a broad differential. No cell block was available for immunohistochemical stains. Immunophenotyping of the subsequent excisional node biopsy showed an anaplastic lymphoma kinase (ALK)‐positive ALCL. This case illustrates a new variant of ALCL. Although ALCL variants, such as small cell and lymphohistiocytic, are well recognized, the plasmacytoid features are an additional potential source for misdiagnosis. This case report shows that a cytopathologist should include ALK‐positive ALCL in the differential diagnosis of plasmacytoid proliferations cell because of the clinical importance of the ALK‐positive ALCL. Diagn. Cytopathol. 2002;26:113–116; DOI 10.1002/dc.10056 © 2002 Wiley‐Liss, Inc.