Sarcomatoid variant of anaplastic large cell lymphoma mimicking a primary breast cancer: a challenging diagnosis

Arch Pathol Lab Med. 2002 Jun;126(6):723-6. doi: 10.5858/2002-126-0723-SVOALC.

Abstract

The sarcomatoid variant of anaplastic large cell lymphoma is one of the rarest histologic variants of this neoplasm. Due to its sarcomatoid features, it is frequently misdiagnosed as a poorly differentiated sarcoma, anaplastic carcinoma, or melanoma. We report the case of a 92-year-old woman with a sarcomatoid anaplastic large cell lymphoma mimicking a primary breast neoplasm. The patient presented with a rapidly enlarging lump in the left breast and nodules in the right axilla. The immunohistochemical profile showed reactivity for leukocyte common antigen, UCHL-1, vimentin, and CD30, but immunoexpression of anaplastic lymphoma kinase was lacking. Anaplastic large cell lymphomas are lymphoid neoplasms of T-cell/null-cell lineage that consistently express the activation marker CD30 and usually carry a gene rearrangement of the anaplastic lymphoma kinase gene. To the best of our knowledge, this is the first reported case of sarcomatoid anaplastic large cell lymphoma presenting as a primary breast neoplasm in which anaplastic lymphoma kinase expression was assessed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Breast Neoplasms / pathology*
  • Cyclophosphamide / administration & dosage
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • Fatal Outcome
  • Female
  • Humans
  • Ki-1 Antigen / analysis
  • Leukocyte Common Antigens / analysis
  • Lymphoma, Large-Cell, Anaplastic / chemistry
  • Lymphoma, Large-Cell, Anaplastic / drug therapy
  • Lymphoma, Large-Cell, Anaplastic / pathology*
  • Male
  • Methotrexate / administration & dosage
  • Prednisolone / administration & dosage
  • Sarcoma / chemistry
  • Sarcoma / drug therapy
  • Sarcoma / pathology*
  • Vimentin / analysis
  • Vincristine / administration & dosage

Substances

  • Biomarkers, Tumor
  • Ki-1 Antigen
  • Vimentin
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Leukocyte Common Antigens
  • Methotrexate