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Is ALK ‐gene rearrangement overlooked in primary gastrointestinal T ‐cell lymphomas? About two cases
Author(s) -
Mneimneh Wadad S.,
Vyas Shikhar Gautam,
Cheng Liang,
Cummings Oscar W.,
Czader Magdalena
Publication year - 2015
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12358
Subject(s) - anaplastic lymphoma kinase , anaplastic large cell lymphoma , cd30 , lymphoma , pathology , gene rearrangement , immunohistochemistry , fluorescence in situ hybridization , large cell , medicine , lymphomatoid papulosis , context (archaeology) , large cell lymphoma , gastrointestinal tract , cancer research , biology , cancer , adenocarcinoma , gene , paleontology , biochemistry , malignant pleural effusion , chromosome , lung cancer
A 41‐year‐old male patient with a history of ankylosing spondylitis and C rohn disease, treated with immunomodulators and disease‐modifying drugs, was diagnosed with a primary intestinal T ‐cell lymphoma that followed a 7.5‐year‐course. This transmural proliferation lacked cytological characteristics of anaplastic large cell lymphoma ( ALCL ), and was CD 8‐positive, and CD 30‐ and anaplastic lymphoma kinase ( ALK )‐negative by immunohistochemistry ( IHC ). However, ALK ‐gene rearrangement ( ALK ‐gr) was detected by fluorescence in situ hybridization ( FISH ) in both initial and persistent disease. The possibility of indolent T‐cell lymphoproliferative disease of the gastrointestinal tract with atypical features (transmural involvement) related to ALK ‐gr was suggested. A previous case of aggressive ‘enteropathy‐associated ALCL ’ in the context of celiac disease was recently reported, which also lacked anaplastic morphology, and where CD 30 and ALK expression was incidentally demonstrated by IHC , and ALK ‐gr subsequently confirmed by FISH . These two recent cases represent two distinct rare entities pertaining to the group of primary intestinal T‐cell lymphomas, and they both show unexpected ALK ‐gr. This suggests that ALK ‐gr has been overlooked in the group of primary intestinal T ‐cell lymphomas. Performing IHC and FISH tests for ALK ‐gr in primary gastrointestinal T ‐cell lymphomas might be of importance, particularly with the advancement of targeted therapy that could impact treatment and prognosis.