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Spontaneous Regression Of A Systemic Alk (+) Anaplastic Large Cell Lymphoma Carrying Alk Gene Rearrangement That Developed After Ppd Tuberculin Skin Test

Bekoz et al., 2015Lymphoma

Bekoz, H. S., Kantarcioglu, B., Tecimer, T., & Sargin, D. (2016). spontaneous regression of a systemic ALK (+) anaplastic large cell lymphoma carrying ALK gene rearrangement that developed after PPD tuberculin skin test. Leukemia & lymphoma, 57(2), 480–482. https://doi.org/10.3109/10428194.2015.1058935

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Abstract

Here we report an ALK (+) ALCL carrying ALK gene rearrangement that developed after a PPD tuberculin skin test, which spontaneously regressed after an excisional lymph node biopsy and is still in c...

Case Details

Disease Location

Left axillary area

Personal Characteristics

38 -year-old male

Clinical Characteristics

Alk + alcl carrying alk gene rearragnement that developed after a ppd tuberculin skin test admitted in october 2008 on recipient of his excisional biopsy pathology in august 2008 he noticed aching and swelling in his left armpit 2-3 days after a purified protein derivative (ppd) skin test had been conducted to his left arm. He also developed high grade fever nonsteroidal anti-inflammatory drugs were prescribed because the first consideration was an allergic reaction, but in the following days the swelling in the left axillary region increased with added symptoms of high grade fever, fatigue, loss of appetite, and weight loss left axillary ultrasound was performed which found multiple conglomerated lymph nodes, up to 3x2.5cm in diameter wbc count was 5300/ul, hb was 12.5g/dl, platelet count was 248000/mcl, ldh was 423u/l, erythrocyte sedimentation rate was 26mm/hour and beta2-microglobulin was 2.2mg/l tuberculosis lymphadenitis was suspected and excisional biopsy was performed biopsy was consistent with alk+ anaplastic large cell lymphoma fluroescent in situ hybridization was positive for alk gene rearrangement ihc staining with alk showed strong nuclear and cytoplasmic staining, consistent with t(2;5)(p23;q35).

Remission Characteristics

Patient reported that fever resolved immediately after the biopsy ldh and beta2-microglobulin levels both normalized PET/CT showed no evidence of disease the patient remains in complete remission as of january 2015 without any kind of treatment

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism reported, but remission occurred after excisional biopsy i.e. Trauma to the tumor/lesion

Clinical Treatment

Excisional biopsy nonsteroidal anti-inflammatory drugs

Non-Clinical Treatment

None reported