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Suyama T, Matsui K, Makihara K, Tsuru M. Isolated Central Nervous System Involvement after Brentuximab Vedotin Treatment for HIV-Positive ALK-Negative Anaplastic Large Cell Lymphoma. Case Rep Hematol 2024; 2024:5534556. [PMID: 38434150 PMCID: PMC10904676 DOI: 10.1155/2024/5534556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Human immunodeficiency virus (HIV)-associated lymphoma poses a high mortality risk despite antiretroviral therapy (ART). Although intermediate- or high-grade B-cell lymphomas are common, anaplastic large-cell lymphomas (ALCLs) are rare and seldom affect the central nervous system (CNS). Herein, we present a case of HIV-associated ALCL with isolated CNS involvement that occurred following the discontinuation of ART that was administered after treatment with brentuximab vedotin (BV)-which does not cross the blood-brain barrier. At the time of CNS recurrence, the patient's CD4 count was 9 cells/mm3. This is the first report of CNS recurrence in HIV-associated ALCL. Considering the high risk of CNS relapse, we suggest initiating CNS prophylaxis in cases of HIV-associated ALCL, particularly in patients receiving CNS-impermeable agents such as BV.
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Affiliation(s)
- Takuya Suyama
- Diabetes and Hematology Division, National Hospital Organization Kanmon Medical Center, 1-1, Sotouracho, Shimonoseki, Yamaguchi 752-8510, Japan
| | - Kumiko Matsui
- Diabetes and Hematology Division, National Hospital Organization Kanmon Medical Center, 1-1, Sotouracho, Shimonoseki, Yamaguchi 752-8510, Japan
| | - Kosuke Makihara
- Surgical Pathology, Kyushu Rosai Hospital, 1-1 Sonekitamachi, Kokura Minami-Ku, Kitakyushu, Fukuoka 800-0296, Japan
| | - Masatoshi Tsuru
- Diabetes and Hematology Division, National Hospital Organization Kanmon Medical Center, 1-1, Sotouracho, Shimonoseki, Yamaguchi 752-8510, Japan
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Brady AL, Fuller CE, Patel S, Hall W, Banki K, Ghimire KB. Primary CNS ALK-negative anaplastic large cell lymphoma: A case report and review of the literature. Radiol Case Rep 2024; 19:393-399. [PMID: 38033666 PMCID: PMC10682537 DOI: 10.1016/j.radcr.2023.09.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/27/2023] [Indexed: 12/02/2023] Open
Abstract
Primary central nervous system (CNS) ALK-negative anaplastic large cell lymphoma (ALCL) is a rare and enigmatic disease, with limited data available in the literature. This case report adds to the existing body of knowledge by describing a unique case of a 68-year-old, immunocompetent male who presented with a single ring-enhancing lesion, which upon further analysis proved to be an ALK-negative ALCL that was primary to the CNS. A comprehensive review of the existing literature is provided, highlighting the genetic characteristics and diverse neuroimaging findings of this disease entity. This report adds valuable information to the understanding of this rare disorder, and highlights the need for further research in the field of primary CNS ALK-negative ALCL.
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Affiliation(s)
- Amy L. Brady
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Sohil Patel
- Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA
| | - Walter Hall
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Katalin Banki
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Krishna B. Ghimire
- Department of Medicine, Hematology and Medical Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
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Colamaria A, Leone A, Carbone F, Dallos Laguado YA, Fochi NP, Sacco M, Fesce C, Sanguedolce F, Giordano G, Iaconetta G, Spetzger U, Coppola L, De Santis E, Coppola G, De Notaris M. Primary Anaplastic-Lymphoma-Kinase-Positive Large-Cell Lymphoma of the Central Nervous System: Comprehensive Review of the Literature. J Clin Med 2023; 12:7516. [PMID: 38137585 PMCID: PMC10743784 DOI: 10.3390/jcm12247516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Primary anaplastic-lymphoma-kinase (ALK)-positive large-cell lymphoma of the central nervous system (PCNS ALK-positive ALCL) is a rare entity, with a limited consensus reached regarding its management. While this pathology often presents as solitary lesions, the occurrence of multiple tumors within the brain is not uncommon. The lack of distinctive radiological features poses a diagnostic challenge, leading to delays in initiating targeted therapy. METHODS We conducted a comprehensive literature search, identifying seventeen publications for qualitative analysis. RESULTS The management options and reported patient outcomes in the literature varied significantly, emphasizing the need for a patient-specific approach. The emergence of ALK-specific inhibitors represents a new frontier in this field, demonstrating promising results. CONCLUSION PCNS ALK-positive ALCL necessitates a comprehensive understanding and optimized management strategies. A tailored therapeutic approach, integrating surgical intervention with radiotherapy and chemotherapy, appears pivotal in addressing this pathology. The implementation of a therapeutic protocol is anticipated for further advancement in this field.
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Affiliation(s)
- Antonio Colamaria
- Division of Neurosurgery, Policlinico “Riuniti”, 71122 Foggia, Italy;
| | - Augusto Leone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
- Faculty of Human Medicine, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Francesco Carbone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | | | - Nicola Pio Fochi
- Division of Neurosurgery, University of Foggia, 71122 Foggia, Italy
| | - Matteo Sacco
- Division of Neurosurgery, “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy;
| | - Cinzia Fesce
- Hematology Unit, University Hospital, 71122 Foggia, Italy;
| | | | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Giorgio Iaconetta
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Uwe Spetzger
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | - Luigi Coppola
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic sciences, La Sapienza University, 00185 Roma, Italy;
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, La Sapienza University, 00185 Roma, Italy;
| | - Matteo De Notaris
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
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Caranfa JT, Liang MC. Anaplastic Large-Cell Lymphoma With Vitreous Humor Involvement. J Vitreoretin Dis 2023; 7:545-547. [PMID: 37974916 PMCID: PMC10649443 DOI: 10.1177/24741264231191668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Purpose: To describe a case of T-cell lymphoma with bilateral vitreous involvement. Methods: A case report was reviewed, and a literature review, including search terms such as "anaplastic large-cell lymphoma (ALCL)" and "T-cell lymphoma with ocular involvement", was performed. Results: A 56-year-old man presented with slurred speech, left-sided weakness, and floaters in his right eye. He was found to have an enhancing right frontal lobe mass with biopsy positive for ALCL. The right eye demonstrated 2+ vitreous cell, with a vitreous biopsy consistent with ALCL. His floaters resolved, and the patient was asymptomatic until he developed floaters in his left eye 1½ years later. A subsequent vitreous biopsy revealed recurrence of ALCL in the fellow eye. Conclusions: ALCL is a rare T-cell lymphoma uncommonly reported as having vitreous infiltration.
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Affiliation(s)
- Jonathan T. Caranfa
- Retina Department, New England Eye Center, Tufts Medical Center, Boston, MA, USA
| | - Michelle C. Liang
- Retina Department, New England Eye Center, Tufts Medical Center, Boston, MA, USA
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Perillo T, Forte J, Messina R, Muggeo P, Grassi M, Pentassuglia E, Raguseo C, Ingravallo G, d'Amati A, Resta M, Speranzon L, Signorelli F, Santoro N. Primary central nervous system anaplastic large cell lymphoma in children: Case presentation and systematic review of literature. Pediatr Blood Cancer 2023; 70:e30529. [PMID: 37402611 DOI: 10.1002/pbc.30529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/18/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Teresa Perillo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Jessica Forte
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Raffaella Messina
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Paola Muggeo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Massimo Grassi
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Enza Pentassuglia
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Celeste Raguseo
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
| | - Giuseppe Ingravallo
- Section of Pathology - Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro,", Bari, Italy
| | - Antonio d'Amati
- Section of Pathology - Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro,", Bari, Italy
| | - Mariachiara Resta
- Neuroradiology, University Hospital Policlinico of Bari, Bari, Italy
| | - Luca Speranzon
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Francesco Signorelli
- Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro,", Bari, Italy
| | - Nicola Santoro
- Pediatric Hematology and Oncology, University Hospital Policlinico of Bari, Bari, Italy
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Pavuluri H, Kv V, Thomas B, Vilanilam GC, Nair P, Narasimhaiah DA, Poyuran R, Menon RN. Clinical Reasoning: A Teenager With Chronic Meningitis-Does Occam's Razor Apply? Neurology 2023; 100:828-835. [PMID: 36746637 PMCID: PMC10136020 DOI: 10.1212/wnl.0000000000206783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/21/2022] [Indexed: 02/08/2023] Open
Abstract
A 14-year-old girl presented with subacute onset headache, fever, and vomiting and was managed initially with antibiotics for suspected bacterial meningitis. Her symptoms further evolved over the next few weeks with systemic signs and symptoms favoring chronic meningitis with raised intracranial pressure. After the etiologic workup was unrevealing, she was started on empirical antituberculous therapy. After a period of partial improvement, symptoms recurred with a new-onset focal seizure. Her imaging findings evolved from features suggestive of focal leptomeningitis to multifocal heterogeneous enhancing cortical and subcortical lesions with hemorrhagic foci, leading to brain biopsy that confirmed diagnosis. Our case highlights the utility of diagnostic biopsy in patients with "chronic meningitis" in uncertain cases rather than confining the approach to the law of parsimony. The decision to initiate empirical therapy in chronic meningitis should be considered on a case-by-case basis and take into account factors, such as clinical examination findings, immune status, recent exposures, and potential risks of treatment. Atypical MRI features should lower the threshold for meningocortical biopsy when indicated.
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Affiliation(s)
- Harini Pavuluri
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Vysakha Kv
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Bejoy Thomas
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - George C Vilanilam
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Prakash Nair
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Deepti A Narasimhaiah
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Rajalakshmi Poyuran
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India
| | - Ramshekhar N Menon
- From the Department of Neurology (H.P., V.K.V., R.N.M.), Department of Imaging Sciences & Interventional Radiology (B.T.), Department of Neurosurgery (G.C.V., P.N.), and Department of Pathology (D.A.N., R.P.), Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India.
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Ruan H, Wang Z, Chen K, Tang X, Ding T, Zhang C, Guan M. The characteristics of cerebrospinal fluid anaplastic large cells in a patient with primary leptomeningeal anaplastic large cell lymphoma. Clin Chim Acta 2022; 537:46-50. [DOI: 10.1016/j.cca.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/03/2022]
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Kaji FA, Martinez-Calle N, Sovani V, Fox CP. Rare central nervous system lymphomas. Br J Haematol 2022; 197:662-678. [PMID: 35292959 PMCID: PMC9310777 DOI: 10.1111/bjh.18128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Central nervous system (CNS) lymphomas are rare malignancies characterised by lymphoid infiltration into the brain, spinal cord, cranial nerves, meninges and/or eyes in the presence or absence of previous or concurrent systemic disease. Most CNS lymphomas are of the diffuse large B-cell lymphoma (DLBCL) subtype for which treatment strategies, particularly the use of high-dose methotrexate-based protocols and consolidation with autologous stem cell transplantation, are well established. Other histopathological subtypes of CNS lymphoma are comparatively less common with published data on these rare lymphomas dominated by smaller case series and retrospective reports. Consequently, there exists little clinical consensus on the optimal methods to diagnose and manage these clinically and biologically heterogeneous CNS lymphomas. In this review article, we focus on rarer CNS lymphomas, summarising the available clinical data on incidence, context, diagnostic features, reported management strategies, and clinical outcomes.
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Affiliation(s)
- Furqaan Ahmed Kaji
- Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Vishakha Sovani
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham, UK
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