광범위한 골수 침범을 동반한 ALK 양성 광범위 B형 대세포림프종 2예의세포형태학적 특징과 CLTC-ALK 재배열의 분자유전학적 분석
Cytomorphology and Molecular Characterization of CLTC-ALK Rearrangement in 2 Cases ofALK-Positive Diffuse Large B-cell Lymphoma with Extensive Bone Marrow Involvement
0
조회
0
다운로드
1
인용
0
참고문헌
초록
Abstract
Aanaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is an unusual disease entity first reported in 1997 as DLBCL with expression of full-length ALK protein. The World Health Organization classification enlists the disease as a rare variant of DLBCL. Herein we describe two cases of ALK-positive DLBCL with cytomorphologic and molecular characteristics for the first time in Korea. The patients were 35-yr-old and 24-yr-old male patients. Immunohistochemical studies on the lymph nodes revealed large sized neoplastic cells with plasmablastic differentiation, which were negative for CD30 and positive for ALK with the characteristic granular staining in the cytoplasmic region. Extensive involvement of bone marrow was observed in both cases showing large, extremely atypical cells. Fluorescence in situ hybridization and molecular studies on the bone marrow aspirate specimens led to the detection of a clathrin (CLTC)/ALK rearrangement. Despite aggressive chemotherapy, the patients died 15 and 17 months after the diagnosis, indicating poor prognosis of the disease entity. This is the first report demonstrating the cytomorphologic findings of ALK-positive DLBCL cells on bone marrow aspirates. (Korean J Lab Med 2008;28:89-94)
참고문헌 (19)
- Jaffe ES, "WHO classification of tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues" (2001), IARC Press
- Delsol G, "A new subtype of large B-cell lymphoma expressing the ALK kinase and lacking the 2; 5 translocation", Blood, 89, pp.1483~1490 (1997)
- Morris SW, "Fusion of a kinase gene, ALK, to a nucleolar protein gene, NPM, in non-Hodgkin's lymphoma", Science, 263, pp.1281~1284 (1994)
- Dirks WG, "Expression and functional analysis of the anaplastic lymphoma kinase (ALK) gene in tumor cell lines", Int J Cancer, 100, pp.49~56 (2002)
- Lamant L, "Expression of the ALK tyrosine kinase gene in neuroblastoma", Am J Pathol, 156, pp.1711~1721 (2000)
- Adam P, "A case of a diffuse large B-cell lymphoma of plasmablastic type associated with the t(2;5)(p23;q35) chromosome translocation", Am J Surg Pathol, 27, pp.1473~1476 (2003)
- Onciu M, "ALK-positive plasmablastic B-cell lymphoma with expression of the NPM-ALK fusion transcript: report of 2 cases", Blood, 102, pp.2642~2644 (2003)
- Bubala H, "ALK-positive diffuse large B-cell lymphoma", Pediatr Blood Cancer, 46, pp.649~653 (2006)
- Chikatsu N, "ALK+, CD30-, CD20- large B-cell lymphoma containing anaplastic lymphoma kinase (ALK) fused to clathrin heavy chain gene (CLTC)", Mod Pathol, 16, pp.828~832 (2003)
- De Paepe P, "ALK activation by the CLTC-ALK fusion is a recurrent event in large B-cell lymphoma", Blood, 102, pp.2638~2641 (2003)
- Gascoyne RD, "ALK-positive diffuse large B-cell lymphoma is associated with Clathrin-ALK rearrangements: report of 6 cases", Blood, 102, pp.2568~2573 (2003)
- Gesk S, "ALK-positive diffuse large B-cell lymphoma with ALK-Clathrin fusion belongs to the spectrum of pediatric lymphomas", Leukemia, 19, pp.1839~1840 (2005)
- McManus DT, "ALK-positive diffuse large B-cell lymphoma of the stomach associated with a clathrin-ALK rearrangement", Hum Pathol, 35, pp.1285~1288 (2004)
- Touriol C, "Further demonstration of the diversity of chromosomal changes involving 2p23 in ALK-positive lymphoma: 2 cases expressing ALK kinase fused to CLTCL (clathrin chain polypeptide-like)", Blood, 95, pp.3204~3207 (2000)
- Pulford K, Morris SW, "Anaplastic lymphoma kinase proteins in growth control and cancer", J Cell Physiol, 199, pp.330~358 (2004)
- Falini B, "ALK expression defines a distinct group of T", null lymphomas ( ALK lymphomas ) with a wide morphological spectrum, 1998, pp.153, 875~886
- Falini B, "Proteins encoded by genes involved in chromosomal alterations in lymphoma and leukemia: clinical value of their detection by immunocytochemistry", Blood, 99, pp.409~426 (2002)
- Bridge JA, "Fusion of the ALK gene to the clathrin heavy chain gene, CLTC, in inflammatory myofibroblastic tumor", Am J Pathol, 159, pp.411~415 (2001)
- Reichard KK, "ALK-positive diffuse large B-cell lymphoma: report of four cases and review of the literature", Mod Pathol, 20, pp.310~319 (2007)