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PAFMJ. 2015; 63(3): 328-332


CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL ANALYSIS OF ANAPLASTIC LARGE CELL LYMPHOMA

Muhammad Sajjad Abbasi, Muhammad Atique, Shahid Jamal, Farhan Akhtar.

Abstract
Objective: To study the clinicopathological and immunohistochemical features of Anaplastic Large Cell Lymphoma (ALCL).
Study Design: The study design was cross sectional descriptive study.
Place and Duration of Study: The study was conducted in Armed forces institute of pathology. The duration of study was two years from 1st Jan 2010 to 31st Dec 2011.
Material and Methods: A total of twenty five consecutive biopsy proven cases of anaplastic large cell lymphoma (ALCL) were selected through non probability, consecutive sampling. The inclusion criteria was, all newly diagnosed patients of ALCL having sufficient tumour material in paraffin embedded tissue blocks with appropriate clinical information regarding age, gender and anatomic location. The exclusion criteria included all poorly fixed specimen. The clinical information regarding age, gender and location was noted. All the cases were evaluated on Haematoxylin and Eosin (H & E). Cases were subjected to Immunohistochemistry (IHC) using CD45 (LCA), CD3, CD 45 RO, CD 15, CD20, CD 30, ALK, EMA, Cytokeratin and classified according to WHO classification of lymphoid neoplasm.
Results: Twenty five cases of anaplastic large cell lymphoma were reported during this time period. Out of 25 cases, 22(88%) were ALCL ALK positive, 2(8%) were ALCL ALK negative and 1(4%) case was cutaneous ALCL. The male to female ratio was 2.5:1. The age range was between 6 years and 70 years with majority of cases in third decade. Seventy six percent were nodal and rest were extranodal. The cervical lymph nodes were the commonest nodal group involved making 15(60 %) cases followed by 3 (12%) cases of axillary lymph nodes. The histopathological appearance showed complete effacement of architecture in 17 (68 %) of cases followed by sinusoidal distribution in 6(24 %) cases while partial effacement of architecture in 2 (8%) of cases. All the cases were positive for CD30 while 23 (92%) cases for CD3, 22 (88 %) cases for ALK and 19 (76%) cases positive for EMA. ALK negative lymphomas were 3(12%) cases.
Conclusion: Anaplastic large cell lymphoma is more common in males and young adults. Nodal involvement is more common. Majority of cases show complete effacement of architecture. All cases are CD 30 positive. Most of cases are anaplastic lymphoma kinase antigen positive.

Key words: Anaplastic large cell lymphoma (ALCL), Anaplastic lymphoma kinase (ALK), Non-Hodgkin lymphoma.



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