Особливості клінічного перебігу анапластичної крупноклітинної лімфоми в дітей. Клінічний випадок

Abstract

Anaplastic large cell lymphoma (ALCL) is a rare type of T-cell non-Hodgkin lymphoma with a characteristic primary localized, mainly extra-bone marrow tumor growth of lymphoid tissue, the clinical picture of which includes lesions of peripheral lymph nodes and extranodal organs, such as bones, skin, lungs, liver, muscles which tissues and bone marrow. Purpose - to acquaint practicing doctors with the features of clinical manifestations, differential diagnosis and course of ALCL in children. Features of the clinical course of ALCL in a child are described. The main diagnostic value of the anamnesis, clinical picture, laboratory, instrumental, immunohistochemical and microscopic research methods, in particular trepan biopsy of this tumor, is highlighted. Microscopic examination of the tissue trepanbioptate show that in half of the cells of the bone marrow, its normal structure is revealed, hematopoietic bone marrow is present with the preservation of all sprouts, with a slightly increased number of megakaryocytes. Half of the cells are filled with solid layers of sharply atypical lymphocyte-like cells with a moderate amount of eosinophilic cytoplasm, the nuclei of tumor cells are large, vesicular, with the formation of 1-2 basophilic nuclei. In the tumor cells there are figures of mitosis, including atypical ones. Single hematopoietic cells of various germs are found between these cells. The conducted immunohistochemical study of tumor cells show that they are positive for common leukocyte antigen (CD4), negative for common cytokeratins, S-100, myogenin, MuoD1, which indicates their hematopoietic origin. Upon further examination, the tumor cells were positive for CD 30, negative for CD3, CD20, CD 43, CD 68, CD11c, tdt, myeloperoxidase, CD 1a. Staining for CD246 reveals a granular cytoplasmic reaction in tumor cells. The histological pattern and immunophenotype of tumor cells correspond to ALCL. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.