Combined Modality Management of Sinonasal Anaplastic Lymphoma Kinase-Positive Anaplastic Large Cell Lymphoma in a Young Adult-Report of a Rare Case.

Authors:
Ahitagni Biswas
Ahitagni Biswas
All India Institute of Medical Sciences
India
Shipra Agarwal
Shipra Agarwal
All India Institute of Medical Sciences
New Delhi | India
Mehar Chand Sharma
Mehar Chand Sharma
All India Institute of Medical Sciences
New Delhi | India
Atul Sharma
Atul Sharma
All India Institute of Medical Sciences
India

J Adolesc Young Adult Oncol 2019 Apr 17. Epub 2019 Apr 17.

3 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.

Sinonasal anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) without nodal involvement is extremely rare and the rarity of this tumor often leads to diagnostic dilemma. It has been predominantly reported in pediatric, adolescent and young adult patients, mostly of Asian origin. A 21-year-old female patient presented with history of epistaxis for 1 year. On clinical and radiological examination, there was a 5 cm mass in the right nasal cavity, ethmoid, and frontal sinus. Biopsy at a local center had shown moderately differentiated squamous cell carcinoma. Rebiopsy at our center showed possibility of a hematolymphoid malignancy(pancytokeratin-, CD45+, CD3-, CD20-) and further immunohistochemistry studies(CD4+, CD43+, CD30+, ALK+) revealed ALK-positive ALCL. Rest of the lymphoma work-up was essentially normal and she had stage IE disease. She was treated with a combination of four cycles of cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone (CHOP) regimen followed by local radiotherapy (36 Gray/20 fractions/4 weeks) by three-dimensional conformal technique. She tolerated the treatment well without any severe toxicity and had complete clinical and radiological response. At last follow-up visit, 40 months from the initial diagnosis, she was alive and disease free. Sinonasal ALK-positive ALCL is a rare tumor, which can be effectively treated with a combination of multiagent CHOP/CHOP-like regimen and local conformal radiotherapy.

Download full-text PDF

Source
https://www.liebertpub.com/doi/10.1089/jayao.2018.0158
Publisher Site
http://dx.doi.org/10.1089/jayao.2018.0158DOI Listing
April 2019
8 Reads

Publication Analysis

Top Keywords

anaplastic large
8
sinonasal anaplastic
8
regimen local
8
alk-positive alcl
8
clinical radiological
8
cell lymphoma
8
treated combination
8
large cell
8
anaplastic lymphoma
8
lymphoma
5
studiescd4+ cd43+
4
immunohistochemistry studiescd4+
4
cd20- immunohistochemistry
4
cd43+ cd30+
4
revealed alk-positive
4
cd30+ alk+
4
alk+ revealed
4
alcl rest
4
lymphoma work-up
4
stage disease
4

Similar Publications