Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Manifesting as a Scalp Hematoma After an Acute Head Injury-a Case Report and Literature Review

Chi-Yung Yeung; Kun-Ting Hong; Chien-Ping Chiang; Yuan-Hao Chen; Hsin-I Ma; Tung-Hang Tsai

doi:10.1016/j.wneu.2015.11.020

Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Manifesting as a Scalp Hematoma After an Acute Head Injury-a Case Report and Literature Review

World Neurosurg. 2016 Apr:88:688.e13-688.e16. doi: 10.1016/j.wneu.2015.11.020. Epub 2015 Nov 23.

Authors

Chi-Yung Yeung¹, Kun-Ting Hong², Chien-Ping Chiang³, Yuan-Hao Chen², Hsin-I Ma², Tung-Hang Tsai⁴

Affiliations

¹ Department of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
² Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
³ Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
⁴ Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. Electronic address: tunghantsai269@gmail.com.

PMID: 26615790
DOI: 10.1016/j.wneu.2015.11.020

Abstract

Background: Anaplastic large cell lymphoma (ALCL) is a malignant non-Hodgkin lymphoma, typically associated with anaplastic lymphoma kinase (ALK) expression. In some cases, lack of ALK translocation correlated with a more unfavorable prognosis.

Case description: We describe a case of ALK(-) ALCL that manifested as a progressive, enlarged, swollen mass on the scalp after an acute head injury in an 84-year-old man. Neither palpable lymph nodes nor any B symptoms were noted on admission. Brain computed tomography showed a hematoma in the right posterior occipital region of the scalp as the only remarkable finding. Débridement and biopsy were performed. Histologic and immunohistochemical analysis of the specimen revealed an ALK(-) ALCL of the scalp. The lymphoma was resistant to bendamustine-containing chemotherapies, ultimately leading to the patient's death within 2 months.

Conclusions: This case report highlights the importance of recognizing the possibility of an ALCL manifesting as a focal inflammatory swelling mass on the scalp.

Keywords: Anaplastic large cell lymphoma (ALCL); Anaplastic lymphoma kinase (ALK); Head injury; Scalp hematoma.

Publication types

Case Reports
Review

MeSH terms

Aged, 80 and over
Anaplastic Lymphoma Kinase
Diagnosis, Differential
Fatal Outcome
Head and Neck Neoplasms / complications*
Head and Neck Neoplasms / diagnosis
Head and Neck Neoplasms / drug therapy
Hematoma / etiology*
Humans
Lymphoma, Large-Cell, Anaplastic / complications*
Lymphoma, Large-Cell, Anaplastic / diagnosis*
Lymphoma, Large-Cell, Anaplastic / drug therapy
Male
Receptor Protein-Tyrosine Kinases / metabolism
Scalp / pathology*
Skin Neoplasms / complications*
Skin Neoplasms / diagnosis
Skin Neoplasms / drug therapy
Treatment Failure

Substances

ALK protein, human
Anaplastic Lymphoma Kinase
Receptor Protein-Tyrosine Kinases