ALK-Positive Anaplastic Large Cell Lymphoma in a Patient With Chronic Lymphocytic Leukemia

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International Journal of Surgical Pathology 2008, doi:10.1177/1066896908324259

ALK-Positive Anaplastic Large Cell Lymphoma in a Patient With Chronic

Lymphocytic Leukemia

Ting Liu, Mai He, Diane L. Carlson, Cyrus Hedvat, and Teruya-Feldstein*

* To whom correspondence should be addressed. E-mail: feldstej@... .

This article reports the case of a 59-year-old patient with an 8-year history of

chronic lymphocytic leukemia (CLL), prostate carcinoma, and squamous cell

carcinoma who developed an ALK-positive anaplastic large cell lymphoma (ALCL).

Lymph node and bone marrow biopsies showed 2 distinct morphologic populations:

(a) the CLL component showing a diffuse monomorphous infiltrate of small

lymphocytes with the typical immunophenotype showing positive CD20, CD5, CD23,

and light chain restriction and ( the ALCL component showing large anaplastic

pleomorphic cells positive for CD30, CD45, ALK, CD45Ro, CD4, and vimentin.

Polymerase chain reaction performed on the lymph node for immunoglobulin heavy

chain and T-cell receptor and showed gene rearrangements after macrodissection

of morphologically distinct populations, indicating confirmed genetically

distinct populations. Despite intensive chemotherapy, the patient died. This

case represents the rare occurrence of an ALK-positive ALCL developing in a

patient with CLL.