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08 February 2016 : Case report  China (mainland)

Successful Chemo-Radiotherapy for Primary Anaplastic Large Cell Lymphoma of the Lung: A Case Report and Literature Review

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Rare disease

Qian ZhaoABCDEF, Yongmei LiuABCDEF, Huijiao ChenCD, Yan ZhangEF, Zedong DuF, Jin WangAEFG, Yongsheng WangAEFG

DOI: 10.12659/AJCR.896096

Am J Case Rep 2016; 17:70-75


BACKGROUND: Primary anaplastic large cell lymphoma (ALCL) of the lung is an extremely rare disease. This disease is a great challenge for pneumologists due to its nonspecific clinical presentations and radiological findings. Appropriate invasive biopsy and immunohistochemistry are important for diagnosis. There is currently no standard treatment.

CASE REPORT: We report a very rare case of primary pulmonary ALCL in a 39-year-old man. The clinical features, imaging, pathological findings, treatment outcomes, and prognosis, are described. Successful treatment outcomes were achieved after 6 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy followed by involved field radiotherapy of 54Gy/27f. The patient was disease-free after follow-up for 65 months.

CONCLUSIONS: Our study found that chemotherapy (such as CHOP) is recognized as the first-line regimen for primary ALCL of the lung. For patients with dyspnea caused by a mass blocking the main bronchus, chemo-radiotherapy may be a reasonable therapeutic option. The prognosis is better for patients with positive ALK staining. CD56(+), age older than 60 years, Ann Arbor stage III or IV, survivin expression, PS>2, and high serum LDH level and IPI scores are the poor prognostic factors of ALCL.

Keywords: Antineoplastic Combined Chemotherapy Protocols - therapeutic use, chemoradiotherapy, Cyclophosphamide - therapeutic use, Doxorubicin - therapeutic use, Lung Neoplasms - therapy, Lymphoma, Large-Cell, Anaplastic - therapy, Prednisone - therapeutic use, Radiotherapy Dosage, Vincristine - therapeutic use

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923