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Clin Neuropathol. 2006 Sep-Oct;25(5):232-6.

Rare primary CNS anaplastic large cell lymphoma in an immunocompetent adult: a clinical-pathologic case report and review case of the literature.

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1
Department of Neurosurgery, National Capitol Consortium, Walter Reed Army Medical Center, Washington DC, USA.

Abstract

OBJECTIVE AND IMPORTANCE:

Isolated anaplastic large cell lymphoma (ALCL) presenting in the primary central nervous system is distinctly uncommon. The authors describe a case that clinically and radiographically simulated a primary glial neoplasm.

CLINICAL PRESENTATION:

A 39-year-old immunocompetent male presented with seizures and a rapidly enlarging right occipital/parietal lesion. Magnetic resonance images demonstrated a right occipitoparietal lesion, hypodense on T1WI, with patchy contrast enhancement with gadolinium and significant white matter edema pattern on T2WI along with mass effect and midline shift.

INTERVENTION:

The patient underwent a frameless stereotactic assisted needle biopsy. There appeared to be a clear demarcation between white matter and tumor with no obvious necrosis. Biopsy showed a proliferation of single cells and poorly cohesive groups of cells with large, pleomorphic nuclei, many containing prominent nucleoli, and a moderate amount of cytoplasm. Immunohistochemical staining revealed CD-30 and ALK-positivity typical of ALCL, a rare form of T-cell lymphoma. An extensive workup revealed neither systemic disease nor evidence of immunocompromise.

CONCLUSION:

Reported in less than 20 patients, primary ALCL in an immunocompetent patient is rarely found intracranially; however, its ability to mimic glial neoplasms as well as other pathologies underlines its importance.

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PMID:
17007446
[Indexed for MEDLINE]
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