Open AccessAnaplastic Large Cell Lymphoma with Oral Manifestation: A Series of Four Cases and Literature Review
Author(s) -
Bruno Augusto Benevenuto de Andrade,
Maria Danielle C. Da Costa Fontes,
Ana Luiza Oliveira Corrêa Roza,
Pablo Agustı́n Vargas,
Michelle Agostini,
Nathalie Henriques Silva Canêdo,
Denize D’Azambuja Ramos,
José Carlos Morais,
Cristiane Milito,
Mário José Romañach
Publication year - 2020
Publication title -
head and neck pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.801
H-Index - 50
eISSN - 1936-0568
pISSN - 1936-055X
DOI - 10.1007/s12105-020-01176-6
Subject(s) - anaplastic large cell lymphoma , cd30 , pathology , medicine , eosinophilic , lymphoma , oral and maxillofacial pathology , immunohistochemistry , cd20 , cytokeratin , differential diagnosis , cd99 , vimentin , orthodontics
The aim of this study was to describe the clinicopathological and immunohistochemical features of four cases of anaplastic large cell lymphoma (ALCL) diagnosed through oral manifestations. Clinical data were collected from charts of a single oral pathology laboratory over a 5-year period (2014-2019) and all cases were evaluated by conventional hematoxylin and eosin staining and an extended immunohistochemical panel comprising CD45, CD20, CD3, CD4, CD7, CD30, CD99, CD138, cytokeratin AE1/AE3, EMA, ALK, MUM-1 and Ki-67. The study included 3 male (75%) and 1 female (25%) patients, with a median age of 44 years. The most common intraoral affected site was the alveolar ridge (50%). Clinically, all cases were characterized as an ulcerated bleeding mass. Microscopically, proliferation of anaplastic large lymphoid cells with medium to large-sized, abundant amphophilic to eosinophilic cytoplasm and eccentric nuclei were observed. All cases were positive for CD30, while two cases strongly express ALK. Two patients died of the disease. Careful correlation of clinical, morphological and immunohistochemical data are necessary to establish the diagnosis of oral manifestation of ALCL since its microscopical features may mimic other malignant tumors. Clinicians and pathologists should consider ALCL in the differential diagnosis when evaluating oral ulcerated swellings exhibiting large lymphoid cells in patients with lymphadenopathy.