Li Jisong, Tian Xiaodong, Wang Mangju, Liu Wei, Guo Xiaochao, Wang Ke, Nong Lin, Wang Wei, Yang Yinmo
Department of General Surgery, Peking University First Hospital, Beijing, China,
Department of Hematology, Peking University First Hospital, Beijing, China.
Onco Targets Ther. 2018 Dec 12;11:9007-9011. doi: 10.2147/OTT.S183298. eCollection 2018.
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a T cell subtype of non-Hodgkin's lymphoma (NHL). Typically, lymphoma rarely infiltrates vascular structure. In this article, we present a case of retroperitoneal ALK-positive ALCL with splenic venous tumor thrombosis. A 62-year-old patient presented to our institute with the symptoms of epigastric pain, abdominal distension, and reduced bowel movement. Physical examination indicated no enlarged peripheral lymph nodes or abdominal mass. Laboratory workup revealed granulocytosis, abnormal coagulation function, and normal level of lactic dehydrogenase (LDH). Contrast-enhanced computed tomography (CT) showed a retroperitoneal mass with involvement of pancreas and duodenum and formation of splenic venous tumor thrombus. Ultrasonography-guided retroperitoneal lesion biopsy confirmed the diagnosis of ALK-positive ALCL. The patient was able to tolerate oral intake after two cycles of chemotherapy and showed no sign of lymphoma by positron emission tomography (PET)-CT after the fourth cycle of chemotherapy. In spite of its rarity, lymphoma should be taken into account as a differential diagnosis of other malignancies with tumor thrombosis.
间变性淋巴瘤激酶（ALK）阳性间变性大细胞淋巴瘤（ALCL）是非霍奇金淋巴瘤（NHL）的一种T细胞亚型。通常情况下，淋巴瘤很少浸润血管结构。在本文中，我们报告一例伴有脾静脉肿瘤血栓形成的腹膜后ALK阳性ALCL病例。一名62岁患者因上腹部疼痛、腹胀和排便减少症状前来我院就诊。体格检查未发现外周淋巴结肿大或腹部肿块。实验室检查显示粒细胞增多、凝血功能异常，乳酸脱氢酶（LDH）水平正常。增强计算机断层扫描（CT）显示腹膜后肿块累及胰腺和十二指肠，并形成脾静脉肿瘤血栓。超声引导下的腹膜后病变活检确诊为ALK阳性ALCL。该患者在两个周期化疗后能够耐受经口进食，在第四个周期化疗后，正电子发射断层扫描（PET）-CT显示无淋巴瘤迹象。尽管罕见，但淋巴瘤应被视为伴有肿瘤血栓形成的其他恶性肿瘤的鉴别诊断之一。
