Open AccessSynchronous diagnosis of anaplastic large cell lymphoma and multiple myeloma in a patient
Author(s) -
Xiaofeng Shi,
Jian-g Wu,
Qian Jiang,
Shuo Zhang,
Wanru Chen,
Xin Yu,
Yichen Liu,
Min Chen,
Jie Peng,
Tiantian Li,
Yan Zhu,
Xiaodong Xi
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022931
Subject(s) - medicine , lenalidomide , multiple myeloma , anaplastic large cell lymphoma , regimen , lymphoma , autologous stem cell transplantation , anaplastic lymphoma kinase , positron emission tomography , pathology , radiology , malignant pleural effusion , lung cancer
Rationale: Synchronous development of both anaplastic large cell lymphoma (ALCL) and multiple myeloma (MM) in a patient is rare. To our knowledge, until now only one case has been reported. Treatment needs to cover both and is a challenge. Here we reported another case and discussed the diagnosis and treatment. Patient concerns: This is a 63-year old woman who presented with a mass in upper abdominal skin. Positron emission tomography/computed tomography (PET/CT) showed the high metabolism in left abdominal skin and left axillary lymph nodes. Histopathologic and immunohistochemical evaluation identified the cutaneous mass as an ALK-negative ALCL. Bone marrow smear showed increased plasma cells which expressed CD38, CD138, and cLambda concomitantly. The increased monoclonal immunoglobulin IgD λ was detected by immunofixation electrophoresis. Diagnoses: Diagnosis of both ALCL and MM was confirmed. Interventions: The patient successively received 6 cycles of B-CHOD regimen, one cycle of ID regimen, 2 cycles of DHAX regimen, one cycle of L-DA-EPOCH and autologous stem cell transplantation (ASCT). Then lenalidomide was performed as a maintenance therapy. Outcomes: Both ALCL and MM achieved complete remission. Lessons: We reported a very rare case with synchronous development of ALCL and MM, in whom a good therapeutic response to chemotherapies followed by ASCT has been observed.