“Double-hit” of DUSP22 and TP63 rearrangements in anaplastic large cell lymphoma, ALK-negative
Kennosuke Karube, Andrew L. Feldman
Abstract
A 69-year-old woman presented with cervical, mediastinal, and axillary lymphadenopathy (panel A, arrow). An excised specimen showed diffuse involvement by atypical large lymphoid cells, occasionally with kidney or horseshoe-like nuclei (panel B, hematoxylin and eosin, objective 310, inset, objective 340). These cells were positive for CD2, CD3, CD30 (panel C, objective 340), and p63 (panel D, objective 340), and negative for CD4, CD5, CD7, CD8, CD15, CD20, ALK, TIA-1 (panel E, objective 340), and granzyme B. Diagnosis of anaplastic large cell lymphoma (ALCL), ALK-negative, was made. Surprisingly, fluorescence in situ hybridization identified the rearrangements of both DUSP22 (panel F) and TP63 (panel G). The patient achieved complete remission after cyclophosphamide, vincristine, doxorubicin, and prednisone therapy, and is without recurrence 7 months after diagnosis.