Primary systemic anaplastic large-cell lymphoma presenting as ascites / 대한내과학회지

ABSTRACT

Here, we report an unusual case of anaplastic large-cell lymphoma presenting as ascites. A 62-year-old man with alcoholic liver cirrhosis was admitted for ascites. The ascites was an exudate, and atypical cells with nuclear irregularity suggesting the presence of a lymphoma were found on cytological examination of the ascites. However, no primary lesion was found after an exhaustive physical, laboratory, endoscopic, and radiologic examination, and the atypical cells were negative for human herpes virus-8 DNA. Therefore, no definitive diagnosis was made. He was followed regularly without chemotherapy. After 30 months, iliopsoas and erector spinae muscle lesions developed. An ultrasonography-guided gun biopsy of the iliopsoas muscle lesion was performed that revealed anaplastic pleomorphic tumor cells. An immunohistochemical study showed that the tumor cells were positive for LCA and CD30 and negative for CK and ALK. The patient was diagnosed with a primary systemic anaplastic large-cell lymphoma. He could not undergo chemotherapy due to acute renal failure and died after 10 days