Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3403
Peer-review started: November 19, 2020
First decision: February 12, 2021
Revised: February 22, 2021
Accepted: March 5, 2021
Article in press: March 5, 2021
Published online: May 16, 2021
Processing time: 160 Days and 18.3 Hours
Primary bone lymphoma (PBL) is an uncommon extranodal disease that represents approximately 1%-3% of lymphomas. Anaplastic lymphoma kinase (ALK) positive anaplastic large-cell lymphoma (ALCL) is an extremely rare type of PBL. The aim of this report is describe the symptoms, diagnosis, and treatment of primary bone ALK-positive ALCL.
A 66-year-old man presented to our hospital with neck and shoulder pain and intermittent fever that lasted for 1 mo. After extensive evaluation, positron emission tomography-computed tomography (CT) examination showed multiple osteolytic bone lesions without other sites lesions. CT-guided biopsy of the T10 vertebral body was performed, and the pathology results showed that neoplastic cells were positive for ALK-1, CD30, and CD3. A diagnosis of primary bone ALK positive ALCL was ultimately made. The patient was in partial response after four cycle soft cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy, and we planned to repeat the biopsy and radiological examination after completion of the fifth cycle of therapy.
Primary bone ALK positive ALCL is a rare disease and physicians should keep in mind that ALCL can present with isolated osseous involvement without nodal involvement, and lymphoma should be considered in the differential diagnosis of primary bone lesions.
Core Tip: Primary bone lymphoma (PBL) is an uncommon extranodal disease that represents approximately 1%-3% of lymphomas. Among PBLs, diffuse large B-cell lymphoma is the most common pathological type, accounting for approximately 70%-80% of all PBLs. The anaplastic large-cell lymphoma (ALCL) subtype of PBL is extremely rare, and it therefore remains unclear whether it is similar to ALCL in general or whether it is a subtype with unique clinical biological characteristics. Furthermore, the prognostic impact of anaplastic lymphoma kinase (ALK) expression in ALCL with primary bone lesions is still under debate. Herein, we report one rare case of primary bone ALK positive ALCL in a 66-year-old man. Our case suggests that physicians should keep in mind that ALCL can present with isolated osseous involvement without nodal involvement, and lymphoma should be considered in the differential diagnosis of primary bone lesions.