Abstract
We describe a single case of a patient with ALK-positive large B-cell lymphoma (ALK+ LBCL) treated in our hospital. The patient was a 61-year-old man who initially presented with a stage III disease involving systemic lymph nodes (LNs), which was diagnosed with immunoblastic lymphoma. He readily responded to 6 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), achieving a long-term complete response. After 5 and a half years, he relapsed with the involvement of left axillary LNs. A biopsy revealed the proliferation of immunoblasts or plasmablasts, which were positive for ALK immunohistochemistry (IHC) with a granular and restricted cytoplasmic staining pattern. The cells were CD20−, cytoplasmic immunoglobulin κ+, and CD138+. Review of the first biopsy confirmed similar IHC results. Cytogenetic and molecular analyses demonstrated t(2;17)(p23;q23), which generated the CLTC-ALK fusion gene. The relapsed lesions were resolved by regional radiotherapy, and the patient is currently free from lymphoma 13 years after the initial presentation. This case report suggests that the outcome of advanced-stage ALK+ LBCL is not necessarily poor and that the disease can be controlled by conventional chemoradiotherapy.
