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| {{CMG}}; {{AE}} {{AS}} | | {{CMG}}; {{AE}} {{AS}} |
| ==Overview== | | ==Overview== |
| Anaplastic large cell lymphoma must be differentiated from other diseases such as [[metastatic]] [[carcinoma]], [[B cell lymphoma]], primary cutaneous T-cell lymphoma, rhabdomyosarcoma, peripheral T-cell lymphoma-not otherwise specified, classical Hodgkin's lymphoma, and diffuse large B cell lymphoma. | | Anaplastic large cell lymphoma must be differentiated from other diseases such as [[metastatic]] [[carcinoma]], [[B cell lymphoma]], [[primary cutaneous T-cell lymphoma]], [[rhabdomyosarcoma]], peripheral T-cell lymphoma-not otherwise specified, [[classical Hodgkin's lymphoma]], and [[diffuse large B cell lymphoma]]. |
| ==Differential diagnosis==
| | ==Differential Diagnosis== |
| * As the appearance of the hallmark cells, pattern of growth (nesting within lymph nodes) and positivity for EMA may mimic [[metastatic]] [[carcinoma]], it is important to include markers for [[cytokeratin]] in any diagnostic panel (these will be negative in the case of anaplastic lymphoma).
| | Anaplastic large cell lymphoma must be differentiated from other diseases such as: |
| * Other mimics include CD30 positive B-cell lymphomas with anaplastic cells (including Hodgkin lymphomas). These are identified by their positivity for markers of B-cell lineage and frequent presence of markers of EBV.
| | * [[Metastatic]] [[carcinoma]] |
| * Primary cutaneous T-cell lymphomas may also be positive for CD30; these are excluded by their anatomic distribution.
| | * [[B cell lymphoma]] |
| * ALK positivity may also be seen in some large cell B-cell lymphomas and occasionally in [[rhabdomyosarcoma]]s.
| | * [[Primary cutaneous T-cell lymphoma]] |
| * Peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS)<ref name="pmid22789917">{{cite journal| author=Ferreri AJ, Govi S, Pileri SA, Savage KJ| title=Anaplastic large cell lymphoma, ALK-negative. | journal=Crit Rev Oncol Hematol | year= 2013 | volume= 85 | issue= 2 | pages= 206-15 | pmid=22789917 | doi=10.1016/j.critrevonc.2012.06.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22789917 }} </ref><ref name="ALK+/ALK-">{{cite web|url=http://www.bloodjournal.org/content/111/12/5496?sso-checked=true|title=ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project}}</ref>
| | * [[Rhabdomyosarcoma]] |
| *Classical [[Hodgkin's lymphoma]]<ref name="pmid22789917">{{cite journal| author=Ferreri AJ, Govi S, Pileri SA, Savage KJ| title=Anaplastic large cell lymphoma, ALK-negative. | journal=Crit Rev Oncol Hematol | year= 2013 | volume= 85 | issue= 2 | pages= 206-15 | pmid=22789917 | doi=10.1016/j.critrevonc.2012.06.004 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22789917 }} </ref>
| | * Peripheral T-cell lymphoma-not otherwise specified |
| *Diffuse large B-cell lymphoma
| | * [[Classical Hodgkin's lymphoma]] |
| | | * [[Diffuse large B cell lymphoma]] |
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| ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
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| ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
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| ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
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| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|[[Metastatic]] [[carcinoma]]
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, [[Metastatic]] [[carcinoma]] demonstrates nesting within lymph nodes, positivity for EMA also observed in anaplastic large cell lymphoma.
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, [[Metastatic]] [[carcinoma]] demonstrates positivity for markers [[cytokeratin]] that distinguish it from anaplastic large cell lymphoma. | |
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| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[B-cell lymphoma]]
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, B-cell lymphoma demonstrates [[CD30]], anaplastic cells, [[ALK]] positivity also observed in anaplastic large cell lymphoma. | |
| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, B-cell lymphoma demonstrates positivity for markers of B-cell lineage and frequent presence of markers of EBV that distinguish it from anaplastic large cell lymphoma.
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| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Primary cutaneous [[T-cell lymphoma]]
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, Primary cutaneous T-cell lymphoma demonstrates [[CD30]] also observed in anaplastic large cell lymphoma. | |
| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On physical exam, Primary cutaneous T-cell lymphoma demonstrates different anatomic distribution that distinguish it from anaplastic large cell lymphoma. | |
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| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| [[Rhabdomyosarcoma]]
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On diagnostic test, [[Rhabdomyosarcoma]] demonstrates [[ALK]] positivity also observed in anaplastic large cell lymphoma. | |
| | style="padding: 5px 5px; background: #F5F5F5;"|
| |
| * On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
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| | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 5
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| | style="padding: 5px 5px; background: #F5F5F5;"|
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| * On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| |
| | style="padding: 5px 5px; background: #F5F5F5;"|
| |
| * On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
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| |}
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| ==References== | | ==References== |
| {{reflist|2}} | | {{reflist|2}} |