Tanaka Hiroaki, Ohwada Chikako, Hashimoto Shinichiro, Sakai Shio, Takeda Yusuke, Abe Daijiro, Takagi Toshiyuki, Ohshima Koichi, Nakaseko Chiaki
Department of Hematology, Oami Hospital, Japan.
Intern Med. 2012;51(2):199-203. doi: 10.2169/internalmedicine.51.6146. Epub 2012 Jan 15.
A 50-year-old woman with a history of aplastic anemia developed cervical lymphadenopathy and atypical lymphocytosis. Atypical cells of lymph nodes were positive for CD3 and CD30 but negative for anaplastic lymphoma kinase (ALK). Bone marrow examination showed trilineage myelodysplasia. She was diagnosed with ALK-negative anaplastic large cell lymphoma (ALCL) with leukemic transformation and myelodysplastic syndrome (MDS) which presumably developed from aplastic anemia. The lymphoma was resistant to intensive chemotherapies, ultimately leading to death. Leukemic presentation of ALK-negative ALCL as an initial manifestation is extremely rare, and the progression of the disease may be influenced by MDS through alteration of immune functions.
一名有再生障碍性贫血病史的50岁女性出现颈部淋巴结病和非典型淋巴细胞增多。淋巴结的非典型细胞CD3和CD30呈阳性，但间变性淋巴瘤激酶（ALK）呈阴性。骨髓检查显示三系骨髓发育异常。她被诊断为伴有白血病转化的ALK阴性间变性大细胞淋巴瘤（ALCL）和可能由再生障碍性贫血发展而来的骨髓增生异常综合征（MDS）。该淋巴瘤对强化化疗耐药，最终导致死亡。ALK阴性ALCL以白血病表现为初始表现极为罕见，疾病进展可能受MDS通过免疫功能改变的影响。
