ALK-1 Positive Anaplastic Large Cell Lymphoma Presenting as Extensive and Exclusive Osseous Involvement: Report of a Rare Association and Review of Literature

Narla, Swetha Lakshmi; Kurian, Ann Joseph; Subramanyan, Annapurneswari; Parameswaran, Ashok

doi:10.7860/jcdr/2018/31109.11040

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“…In patients with knee prosthesis lymphomas are rare, and among ALCL cases only ALK-negative variants have been documented [ 5 ]. Among bony ALCL cases, common sites include the iliac bones [ 6 ], the sternum [ 7 ], the proximal femur [ 8 ], vertebrae, and ribs [ 9 , 10 , 11 ]. Primary non-Hodgkin’s lymphoma of the knee joint has also been reported, and in rare cases, it has been found to involve the synovium [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Anaplastic Large Cell Lymphoma of the Knee Joint

Zade,

Rao,

Patil

et al. 2023

JOCR

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Introduction: Anaplastic large cell lymphoma (ALCL), which makes up only 2–5% of instances of NHL, is a rare and aggressive form of the disease. Anaplastic Lymphoma Kinase (ALK)-positive ALCL is a variant of the illness that is identified by the presence of an ALK gene fusion. The disease is most commonly confined to the nodes, but extranodal spread has been reported. Skin and soft tissue are the most frequently identified locations for extranodal involvement, while joints are extremely rare. We describe a rare case of ALCL affecting the knee joint that is ALK -positive. Case Report: A 51-year-old female presented with pain in her right knee. It was diagnosed as synovitis and treated accordingly. The symptoms did not relieve and a magnetic resonance imaging (MRI) scan was performed that indicated a meniscus tear. She was treated for it; however, the symptoms worsened. She underwent two more scans (1 MRI and 1 PET) that indicated an enhancing polypoidal mass in the knee joint, and two arthroscopic procedures. The histopathology report indicated an ALK-positive ALCL. She was treated with Brentuximab vedotin + CHP followed by involved-site radiotherapy to the postoperative region with margins. The patient has had a complete clinical and pathological response which was assessed after 1 year from the start of the treatment. Conclusion: This is the first instance of primary ALK-positive ALCL affecting the knee joint that has been documented, to the best of our knowledge. The case emphasizes the significance of taking ALCL into account when determining the differential diagnosis of knee joint tumors as well as the requirement for a thorough assessment of extranodal involvement. Keywords: Lymphoma, knee joint, ALCL, extranodal lymphoma, ISRT, chemotherapy, arthroscopic surgery.

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