A premature infant male was born at 30 weeks’ gestation with severe coagulopathy and thrombocytopenia. Over the first days of his life, the patient developed evidence of immune hyperactivation with adenopathy, hepatosplenomegaly, and elevated ferritin. Although the patient met diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH), flow cytometric based assays were not consistent with primary HLH. A lymph node and bone marrow biopsy eventually revealed the presence of anaplastic lymphoma kinase+anaplastic large cell lymphoma. To our knowledge, this is the earliest presentation of a lymphoma, and expands the known timeframe of lymphomagenesis.
Cleveland Clinic, Cleveland, Ohio
The authors declare no conflict of interest.
Reprints: Reema Mathanda, MD, Cleveland Clinic Children’s Hospital, Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, 9500 Euclid Avenue, Cleveland, OH 44195 (e-mail: MATHANR@ccf.org).
Received November 9, 2018
Accepted January 15, 2019