Anaplastic large cell lymphoma, also known as ALCL, is a type of non-Hodgkin-lymphoma that can arise in two different states: It can present itself as a nodal lymphoma (a lymphoma that attacks tissues that fight infections, such as the bone marrow, spleen, thymus, and lymph nodes) or it can be found in extranodal locations, such as the skin. This disease has been known to occur in people of all ages, but is most common in children and young adults. It occurs twice as often in men as it does in women, and accounts for approximately one in every fifty cases of lymphoma.
Anaplastic Large Cell Lymphoma Signs & Symptoms
Among the first indicators of anaplastic large cell lymphoma is a painless swelling in the neck, groin, and/or armpits due to groups augmented lymph nodes. It should be noted that this disease often affects multiple groups of lymph nodes. Additionally, patients may experience a loss of appetite and/or fatigue. Less common symptoms include night sweats, weight loss, and unexplained high core-body temperatures.
Anaplastic Large Cell Lymphoma Diagnosis
To diagnose anaplastic large cell carcinoma, part or all of an enlarged lymph node must be removed so that cells from the tissue can be examined under a microscope. The microscopic evaluation is known as a histological examination and the tissue removal is known as a biopsy. Biopsies must be performed by a qualified surgeon, but are usually considered to be minor operations that can easily be performed while the patient is under local or general anaesthetic.
An important diagnostic feature of ALCL is an immunopositivity for CD30. CD30, also reffered to by the term TNFRSF8, is a cell membrane protein that regulates a process called apoptosis, or programmed cell death. CD30 immunopositivity results in populations of cells that do not die when they are supposed to and, thus, proliferate into various forms of neoplasia.
Immunopositivity for CD30 is indicated by the presence of certain “hallmark” cells. These cells have morphological variants such as kidney-shaped nuclei and an overabundance of cytoplasm. Recognizing these variants, among many others that may indicate but are not exclusive to this disease, are useful in properly diagnosing this type of lymphoma.
Anaplastic Large Cell Lymphoma Staging
- Stage I: If only one group of lymph nodes are affected by anomalous variants, then the ALCL is considered to be in this stage.
- Stage II: If more than one group of lymph nodes is affected, but all of the affected groups are either above or below the diaphragm, then the ALCL resides within this category.
- Stage III: Stage III characterizes ALCL cases in which lymphoma is present in groups of lymph nodes located above and below your diaphragm.
- Stage IV: When ALCL has invaded parts of the body outside of the lymph nodes, such as the bone marrow, lungs, or the liver, the cancer is considered to be in this category.
Anaplastic Large Cell Lymphoma Treatment
- ALCL typically requires intense chemotherapy treatment. This lymphoma responds well to chemo and, in many cases, will completely disappear as a result. There is, though, always a risk that the disease will return, in which case additional chemo will be administered to control the growth.
- Radiotherapy is commonly utilized when the lymphoma is very localized, as in Stage I ALCL. This is because radiotherapy, though it destroys the cancerous cells, also destroys healthy tissue.
- Steroids may be proscribed alongside chemotherapy to help the patient cope with tiredness and nausea, but is not a curative treatment.
- Research is indicating that this type of lymphoma can be successfully treated with bone marrow or stem cell infusion alongside high doses of chemotherapy. This approach, however, lacks compelling research and carries with it many serious side effects.
Anaplastic Large Cell Lymphoma Prognosis
Relapses frequently occur during treatment, but can usually be controlled with chemotherapy. The overall survival rate for patients with anaplastic large cell carcinoma is quite high. In fact, the disease yields the highest survival rates of any aggressive lymphoma: the five-year survival is 70%.
