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Transformation of recurrent ALK-positive anaplastic large-cell lymphoma from common pattern to composite pattern (lymphohistiocytic and small-cell pattern) with a change in CD30 expression

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Abstract

ALK-positive anaplastic large-cell lymphoma (ALK + ALCL) is characterized by expression of ALK and CD30. The current World Health Organization (WHO) classification recognizes five morphologic patterns: common, small-cell, lymphohistiocytic, Hodgkin-like, and composite. There are few reports about the morphologic transformation of ALK + ALCL. Today, we report an intriguing case of presumed transformation from common-pattern to composite-pattern (lymphohistiocytic and small-cell pattern) ALK + ALCL, with CD30 expression changing from positive to negative. This case expands understanding of morphologic transformation between different subtypes of ALK + ALCL and highlights common diagnostic pitfalls, including atypical morphology and negative CD30. Morphologic transformation of ALK + ALCL should be assigned importance, and comprehensive clinical history, histologic and immunophenotypic evaluation are vital to rendering the correct diagnosis of ALK + ALCL.

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Funding

1·3·5 project for disciplines of excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University, 2021HXFH027, Sha Zhao

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Authors and Affiliations

  1. Department of Pathology, West China Hospital, Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, Sichuan, China

    Liu Ji & Sha Zhao

  2. Department of Pathology, School of Basic Medical Science & Third Hospital, Peking University Health Science Center, Beijing, China

    Cuiling Liu

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  1. Liu Ji
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  2. Cuiling Liu
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  3. Sha Zhao
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Correspondence to Sha Zhao.

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Ji, L., Liu, C. & Zhao, S. Transformation of recurrent ALK-positive anaplastic large-cell lymphoma from common pattern to composite pattern (lymphohistiocytic and small-cell pattern) with a change in CD30 expression. Int J Hematol 118, 131–134 (2023). https://doi.org/10.1007/s12185-023-03553-7

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  • DOI: https://doi.org/10.1007/s12185-023-03553-7

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