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Scientific article
English

ALK-positive anaplastic large-cell lymphoma: strong T and B anti-tumour responses may cause hypocellular aspects of lymph nodes mimicking inflammatory lesions

Published inEuropean journal of haematology, vol. 71, no. 4, p. 243-249
Publication date2003
Abstract

The anaplastic large cell lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma which occurs in children mostly. The ALK protein is highly immunogenic and elicits both humoral and cellular immune responses. A 15-yr-old child presented with fever and adenopathy and did not respond to antibiotics. Biopsy of the enlarged lymph node contained almost no lymphoid element except for a few CD8-positive T cells, plasma cells and isolated CD30-positive blasts. The patient's condition improved following lymphadenectomy but relapse occurred 3 months later with multiple nodes, high fever and an abdominal mass. This time an ALK-positive ALCL was diagnosed and the retrospective analysis of the initial biopsy revealed rare, isolated ALK+ cells. Molecular analysis showed T-cell clones and oligoclonal B cells in both biopsies and peripheral blood of the patient. The tumour cells harbour a t(2;5) translocation, revealing a null phenotype by immunohistochemistry and no evidence for T-cell clonality by Southern blotting. The patient's serum contained anti-ALK antibodies. Our findings suggest that the T-cell clones and anti-ALK antibodies in this patient constitute an anti-tumour response that caused the hypocellularity of the initial lymph node. Hypocellular and oedematous lymph nodes occurring in a child with evocative symptoms should be tested for the presence of ALK.

Keywords
  • Adolescent
  • Antigens
  • CD30/biosynthesis
  • B-Lymphocytes/ immunology/metabolism
  • Blotting
  • Southern
  • Female
  • Humans
  • Immunoblotting
  • Immunohistochemistry
  • Inflammation
  • Lymph Nodes/cytology/pathology
  • Lymphatic Metastasis
  • Lymphoma
  • Large B-Cell
  • Diffuse/ genetics/ pathology
  • Non-Hodgkin/genetics
  • Models
  • Genetic
  • RNA
  • Messenger/metabolism
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • T-Lymphocytes/ immunology
  • Time Factors
  • Translocation
Citation (ISO format)
BORISCH, Bettina et al. ALK-positive anaplastic large-cell lymphoma: strong T and B anti-tumour responses may cause hypocellular aspects of lymph nodes mimicking inflammatory lesions. In: European journal of haematology, 2003, vol. 71, n° 4, p. 243–249. doi: 10.1034/j.1600-0609.2003.00144.x
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ISSN of the journal0902-4441
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