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Acute Spontaneous Tumor Lysis Syndrome as the Initial Presentation of ALK-Positive Diffuse Large B-Cell Lymphoma

Chapman-Fredricks, Jennifer MD*; Blieden, Clifford MD; Sandoval, Jose D. MD; Ernani, Vinicius MD; Ikpatt, Offiong Francis MD, PhD*

Applied Immunohistochemistry & Molecular Morphology: April 2014 - Volume 22 - Issue 4 - p 317–321
doi: 10.1097/PAI.0b013e3182275c02
Case Report

Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a recently described, uncommon form of DLBCL, which has been seen primarily in young men and which presents with advanced disease. The fact that ALK-positive DLBCL is an uncommon diagnosis is likely due to the combined effects of this being an uncommon disease coupled with the challenges in the pathologic identification of this neoplasm. Prompt and accurate identification of this tumor is becoming increasingly important, however, as we enter the era of therapeutic ALK inhibitors, which are currently undergoing study in several clinical trials. Here, we report a case of ALK-positive DLBCL in a 39-year-old male patient who presented with spontaneous tumor lysis syndrome. We review the clinical, morphologic, immunohistochemical, and molecular aspects of this case and of ALK-positive DLBCL in general, with the purpose of bringing to light the existence of this disease and its potential future therapy.

*Department of Pathology and Laboratory Medicine, Division of Hematopathology

Department of Pathology and Laboratory Medicine

Department of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL

The authors declare no conflict of interest.

Reprints: Jennifer Chapman-Fredricks, MD, Department of Pathology and Laboratory Medicine, Division of Hematopathology, University of Miami, Jackson Memorial Hospital, 1611 NW 12th Avenue, East Tower, Room 2044. Miami, FL (e-mail:

Received April 15, 2011

Accepted June 1, 2011

© 2014 Lippincott Williams & Wilkins, Inc.