Ki‐1‐positive anaplastic large cell lymphoma initially diagnosed as Hodgkin's disease by fine needle aspiration (FNA) cytology

Abstract

A 45-year-old male presented with a large mass in the left axilla. FNA cytology was interpreted as Hodgkin's disease (HD), lymphocyte depletion (LD) type, but histopathologic and immunohistochemical examination showed features of Ki-1-positive anaplastic large cell lymphoma. Unrepresentative sampling by the FNA from the tumour periphery resulted in a false impression of dual reactive and neoplastic cell populations, which together with the frequent Reed-Sternberg-like cells led to the initial erroneous impression of HD. Therefore, the cytologic diagnosis of HD, LD should be approached with caution.

Cytomorphologic Differentiation of Hodgkin’s Lymphoma and Ki-1+ Anaplastic Large Cell Lymphoma in Fine Needle Aspirates

“…One of the most difficult situations in diagnostic cytopathology is the differentiation between HL and ALCL, 19,23 mainly because of the overlapping morphologic features of the 2 diseases: both are characterized by abnormal cells in a background of reactive lymphocytes and granulocytes. The number of abnormal cells and their spectrum differ significantly in each disease.…”

“…A review of the English-language literature revealed very few studies discussing in detail the cytomorphologic features of the 2 entities. [21][22][23][24] To our knowledge, no study has attempted to comprehensively differentiate the cytomorphologic characteristics of either disease. In this study we attempted to determine if we could differentiate between the 2 entities by identifying the salient cytomorphologic features of each one.…”

“…Several studies have looked at the cytomorphologic features of both diseases. [21][22][23][24] The difficulty in differentiating the 2 diseases is the close similarities in their morphology and phenotypic characteristics. They are both characterized by large, pleomorphic, malignant cells in a background of benign, polymorphous, inflammatory or lymphoid infiltrate.…”

CD-30(Ki-1)–Positive Anaplastic Large Cell Lymphoma in a Pleural Effusion

“…14 Cytodiagnosis of Ki-1 ALCL by fine needle aspiration has been described in the form of isolated case reports or small series of cases during the past decade. 1,2,9,11,12,[15][16][17]19,[22][23][24] Still more rare is the diagnosis of this neoplasm by exfoliative cytology, such as urine, 21 cerebrospinal fluid, 6,19 ascitic fluid 5 and pleural effusion. 4-6,10,13,18, 19 We report a case that was diagnosed initially by cytologic examination of pleural fluid and confirmed by immunocytochemical staining.…”

Value of Fine Needle Aspiration Cytology in the Initial Diagnosis of Hodgkin’s Disease

“…Confusion with ALCL is a well-known pitfall not only in cytology [7][8][9][10] but also in histologic and immunohistochemical studies. 11 the tumor population and smoother nuclear contours should suggest nasopharyngeal carcinoma rather than HD.…”