Anatomic Pathology and Cytopathology Department, University Hospital Dr. José Eleuterio González, Autonomous University of Nuevo León, Monterrey, Mexico.
Thorac Cancer. 2024 May;15(13):1103-1105. doi: 10.1111/1759-7714.15293. Epub 2024 Mar 24.
A 56-year-old woman debuted with a palpable painless mass in the anterior thorax wall at the level of the second and third right parasternal intercostal space, which progressively increased in size over 5 months accompanied by localized skin rash, mild dyspnea and chest pain when changing position. Imaging studies showed a soft tissue mass measuring 75 × 62 mm and a density of 34 Hounsfield Units that had caused the lysis of the costal arches and grew expansively towards the anterior mediastinum, without identifying mediastinal adenopathies only by this imaging method. Core biopsy was performed, which was initially diagnosed as histiocytic sarcoma (HS); however, when the diagnostic panel was expanded to include molecular and NGS studies, the final diagnosis was anaplastic large cell lymphoma with ALK::ATIC fusion. Here, we report a very rare neoplasm with unusual clinical presentation, histopathology and molecular features.
一位 56 岁女性，最初在前胸壁第二和第三右胸骨旁肋间出现可触及的无痛性肿块，大小在 5 个月内逐渐增大，伴有局部皮疹、轻度呼吸困难和体位改变时胸痛。影像学研究显示一个软组织肿块，大小为 75×62mm，密度为 34 亨氏单位，导致肋弓裂解并向胸骨前间隙扩张，仅通过这种影像学方法未识别纵隔淋巴结病。进行了核心活检，最初诊断为组织细胞肉瘤（HS）；然而，当诊断小组扩大到包括分子和 NGS 研究时，最终诊断为具有 ALK::ATIC 融合的间变性大细胞淋巴瘤。在这里，我们报告了一种非常罕见的具有不同寻常临床表现、组织病理学和分子特征的肿瘤。
