Llamas Domínguez Alondra Esthefanía, Palma Zapata Julio A, Ponce Campos Silvia Denise, Palma Zapata Juliana, Jacobo Medrano Elvia, Cisneros Garza Pedro
Medicine, Autonomous University of Aguascalientes, Aguascalientes, MEX.
Pneumology, Institute of Security and Social Services for State Workers, Aguascalientes, MEX.
Cureus. 2024 Feb 29;16(2):e55258. doi: 10.7759/cureus.55258. eCollection 2024 Feb.
Anaplastic large cell lymphomas (ALCL) are a group of sporadic malignancies that generally have an aggressive clinical course, especially the subtype of anaplastic lymphoma kinase (ALK)-negative ALCL. The appropriate diagnostic study modalities must be chosen to make an accurate diagnosis and promptly initiate specific treatment. We present the clinical case of a 72-year-old male patient with dyspnea on small efforts accompanied by diaphoresis and a weight loss of 10 kg in two months. Physical examination revealed adenopathy in the cervical region and bilateral pleural effusion. The pleural and lung biopsies revealed poorly differentiated metastatic adenocarcinomas. A multidisciplinary analysis was carried out; the typical clinical-radiographic presentation of adenocarcinoma was ruled out with immunohistochemistry, thus determining a diagnosis of ALK-negative anaplastic large cell non-Hodgkin's lymphoma. This case represented a diagnostic and therapeutic challenge since it is a rare entity with a poor prognosis, and there are only a few studies about the choice of appropriate chemotherapy in these patients.
间变性大细胞淋巴瘤（ALCL）是一组散发性恶性肿瘤，通常具有侵袭性的临床病程，尤其是间变性淋巴瘤激酶（ALK）阴性的ALCL亚型。必须选择合适的诊断研究方式以做出准确诊断并及时启动特异性治疗。我们报告一例72岁男性患者的临床病例，该患者轻微活动后即出现呼吸困难，伴有多汗，且在两个月内体重减轻10kg。体格检查发现颈部淋巴结肿大及双侧胸腔积液。胸膜和肺部活检显示低分化转移性腺癌。进行了多学科分析；通过免疫组织化学排除了腺癌典型的临床-影像学表现，从而确诊为ALK阴性间变性大细胞非霍奇金淋巴瘤。该病例代表了一个诊断和治疗挑战，因为它是一种预后不良的罕见疾病，并且关于这些患者合适化疗方案选择的研究很少。
