Systemic Capillary Leak Syndrome as an Initial Presentation of ALK-Negative Anaplastic Large Cell Lymphoma
Figure 1
Characteristic features of this case of anaplastic lymphoma kinase-negative (ALK-) anaplastic large cell lymphoma (ALCL). (a) Large pleomorphic neoplastic cells with abundant cytoplasm, eccentric nuclei, and brisk mitotic activity (black arrows); Hallmark cells with horseshoe- or kidney-shaped nuclei are present (white arrows). (b) Neoplastic cells show strong membrane and Golgi expression of CD30. (c) Focal immunoreactivity with antibody for the cytotoxic granule protein, Perforin. (d) ALK expression is lacking in this case. (e) High Ki-67 expression, denoting a worse prognosis. (f) Correlated multiparametric flow cytometric analysis demonstrating an abnormal population of T cells (in red) with expression of surface CD4 and lacking surface CD7. Normal T cells (in blue) show normal expression of CD7 and CD4 and include a CD4− subset, which corresponds to the CD8+ T cells. (Black: B cells).
