Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho 373, Prédio Do CCS, Bloco K, 2° andar, Sala 56, Ilha da Cidade Universitária, Rio de Janeiro, RJ, 21.941-902, Brazil.
Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (FOP-UNICAMP), Piracicaba, Brazil.
Head Neck Pathol. 2020 Dec;14(4):991-1000. doi: 10.1007/s12105-020-01176-6. Epub 2020 May 21.
The aim of this study was to describe the clinicopathological and immunohistochemical features of four cases of anaplastic large cell lymphoma (ALCL) diagnosed through oral manifestations. Clinical data were collected from charts of a single oral pathology laboratory over a 5-year period (2014-2019) and all cases were evaluated by conventional hematoxylin and eosin staining and an extended immunohistochemical panel comprising CD45, CD20, CD3, CD4, CD7, CD30, CD99, CD138, cytokeratin AE1/AE3, EMA, ALK, MUM-1 and Ki-67. The study included 3 male (75%) and 1 female (25%) patients, with a median age of 44 years. The most common intraoral affected site was the alveolar ridge (50%). Clinically, all cases were characterized as an ulcerated bleeding mass. Microscopically, proliferation of anaplastic large lymphoid cells with medium to large-sized, abundant amphophilic to eosinophilic cytoplasm and eccentric nuclei were observed. All cases were positive for CD30, while two cases strongly express ALK. Two patients died of the disease. Careful correlation of clinical, morphological and immunohistochemical data are necessary to establish the diagnosis of oral manifestation of ALCL since its microscopical features may mimic other malignant tumors. Clinicians and pathologists should consider ALCL in the differential diagnosis when evaluating oral ulcerated swellings exhibiting large lymphoid cells in patients with lymphadenopathy.
本研究旨在描述通过口腔表现诊断的 4 例间变大细胞淋巴瘤（ALCL）的临床病理和免疫组织化学特征。临床数据来自一个口腔病理实验室在 5 年期间（2014-2019 年）的图表，所有病例均通过常规苏木精和伊红染色以及包括 CD45、CD20、CD3、CD4、CD7、CD30、CD99、CD138、细胞角蛋白 AE1/AE3、EMA、ALK、MUM-1 和 Ki-67 的扩展免疫组织化学小组进行评估。该研究包括 3 名男性（75%）和 1 名女性（25%）患者，中位年龄为 44 岁。最常见的口腔受累部位是牙槽嵴（50%）。临床上，所有病例均表现为溃疡性出血性肿块。显微镜下，观察到中等至大细胞大小的间变大淋巴样细胞增殖，具有丰富的嗜碱性至嗜酸性细胞质和偏心核。所有病例均对 CD30 阳性，而 2 例强烈表达 ALK。2 例患者死于该疾病。由于其显微镜特征可能模仿其他恶性肿瘤，因此需要仔细关联临床、形态学和免疫组织化学数据以建立口腔 ALCL 的诊断。当评估具有淋巴结病的患者中出现大淋巴细胞的口腔溃疡性肿胀时，临床医生和病理学家应考虑 ALCL 作为鉴别诊断。
