ALK-1 Positive Anaplastic Large Cell Lymphoma Presenting as Extensive and Exclusive Osseous Involvement: Report of a Rare Association and Review of Literature ED01-ED03
Dr. Swetha Lakshmi Narla,
320 Anna Salai, Teynampet, Chennai-600035, Tamil Nadu, India.
Primary Bone Lymphomas (PBLs) are uncommon. Most of these tumours are Non Hodgkin Lymphoma (NHL) with Diffuse Large B-cell Lymphoma (DLBCL) being the most common. Anaplastic Large Cell Lymphoma (ALCL) constitutes approximately 2% of all NHL and involves both nodal and extra nodal sites. ALCL presenting as exclusive and extensive bone involvement is rare. We report a case of 31-year-old man who presented with osseous involvement only. Imaging showed multiple lytic lesions involving the vertebral column, ribs and sternum. Clinical differential diagnosis included osteomyelitis and bone neoplasms. Histopathology and immunohistochemistry of the lytic lesion proved it to be Anaplastic Lymphoma Kinase (ALK-1) positive ALCL. The patient relapsed three months after completion of six cycles of combination chemotherapy with Cyclophosphamide, Hydroxydaunorubicin, Vincristine and Prednisone (CHOP).