Sekar Mithraa Devi, Gochhait Debasis, Venkatesan Devi, Siddaraju Neelaiah, Kar Rakhee
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
J Cytol. 2024 Apr-Jun;41(2):59-66. doi: 10.4103/joc.joc_50_23. Epub 2024 Apr 24.
Anaplastic large cell lymphoma (ALCL), a unique non-Hodgkin lymphoma (NHL), is a CD30-positive neoplasm of T-cell lineage. Its distinctive yet variable cytomorphology makes diagnosing fine needle aspiration cytology (FNAC) challenging. This study was undertaken to study the cytomorphology and the utility of immunocytochemical (ICC) stains on cytology in ALCL and to discuss their morphological differential diagnosis.
The present study was conducted in the Department of Pathology of a tertiary care center. A retrospective review was done from January 2017 to July 2022, and all histopathologically and immunohistochemically (IHC) diagnosed cases of ALCL were taken and correlated with the cytological diagnosis.
Twenty-one cases of histopathology examination and IHC-proven cases of ALCL were retrieved from the departmental archives and reviewed. The ages ranged from 3 to 80 years (median age 28 years). Commonly noted cytomorphologic features included singly dispersed large pleomorphic cells, hallmark cells, and Reed-Sternberg-like cells. CD15, CD30, epithelial membrane antigen, and anaplastic lymphoma kinase-1 were some of the ICC stains used in this study. All 21 cases had cytology correlation. Fourteen cases had concordant cyto-histological correlation. Seven cases of histopathologically proven ALCL were reported as Hodgkin lymphoma (HL) in three, ALCL/anaplastic diffuse large B-cell lymphoma, HL/ALCL, poorly differentiated carcinoma, and NHL in one case each on cytology.
ALCL has a reasonably distinct cytomorphologic appearance and ICC staining pattern, and a careful interpretation of both helps arrive at a reliable FNAC diagnosis.
间变性大细胞淋巴瘤（ALCL）是一种独特的非霍奇金淋巴瘤（NHL），是T细胞系的CD30阳性肿瘤。其独特但多变的细胞形态学使得细针穿刺细胞学检查（FNAC）诊断具有挑战性。本研究旨在研究ALCL的细胞形态学以及免疫细胞化学（ICC）染色在细胞学中的应用，并讨论其形态学鉴别诊断。
本研究在一家三级医疗中心的病理科进行。对2017年1月至2022年7月进行了回顾性研究，纳入所有经组织病理学和免疫组织化学（IHC）诊断的ALCL病例，并与细胞学诊断进行对照。
从科室档案中检索并回顾了21例经组织病理学检查和IHC证实的ALCL病例。年龄范围为3至80岁（中位年龄28岁）。常见的细胞形态学特征包括单个散在的大异形细胞、标志性细胞和里德-施特恩伯格样细胞。本研究中使用的ICC染色包括CD15、CD30、上皮膜抗原和间变性淋巴瘤激酶-1。所有21例病例均有细胞学对照。14例病例有一致的细胞-组织学对照。7例经组织病理学证实的ALCL病例在细胞学检查中，3例被报告为霍奇金淋巴瘤（HL），1例分别被报告为ALCL/间变性弥漫性大B细胞淋巴瘤、HL/ALCL、低分化癌和NHL。
ALCL具有相当独特的细胞形态学表现和ICC染色模式，对两者进行仔细解读有助于得出可靠的FNAC诊断。
