Primary central nervous system ALK-negative anaplastic large cell lymphoma: a case report and literature review

Ann Palliat Med. 2022 Apr;11(4):1554-1560. doi: 10.21037/apm-21-557. Epub 2021 Jul 1.

Abstract

Primary central nervous system anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL) is an extremely rare type of primary central nervous system lymphoma (PCNSL). There are only nine cases reported in the literature to date, most of which have an overall survival time of no more than 8 months. Herein, we report such a rare case who has a good outcome with the longest survival time and perform a review of the literature. A 19-year-old male patient was admitted to the hospital complaining of dizziness. CT and MRI imaging showed a heterogeneous enhanced lesion in the left parieto-occipital lobe and the leptomeninges of the occipital lobe and the cerebellum. The lesion was resected and confirmed to be ALK-negative ALCL by pathological examination. Then, the patient received 10 cycles of chemotherapy with high-dose methotrexate (HD-MTX) and whole-brain radiotherapy. The patient recovered well and was regularly followed up. He was free of symptoms without recurrence on imaging examination 3 years later. ALCL is a rare type of PCNSL. HD-MTX combined with radiation is an effective therapeutic approach. However, further prospective studies with a large number of patients are needed to identify the biological characteristics of this rare type of PCNSL.

Keywords: Anaplastic large cell lymphoma (ALCL); anaplastic lymphoma kinase (ALK); case report; primary central nervous system lymphomas (PCNSLs); treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anaplastic Lymphoma Kinase
  • Central Nervous System
  • Humans
  • Lymphoma, Large-Cell, Anaplastic* / diagnosis
  • Lymphoma, Large-Cell, Anaplastic* / drug therapy
  • Lymphoma, Large-Cell, Anaplastic* / pathology
  • Male
  • Prospective Studies
  • Receptor Protein-Tyrosine Kinases / metabolism
  • Receptor Protein-Tyrosine Kinases / therapeutic use
  • Young Adult

Substances

  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases