Lab Med Online.  2018 Apr;8(2):56-61. 10.3343/lmo.2018.8.2.56.

Anaplastic Large Cell Lymphoma with Massive Eosinophilia and Complex Karyotype Initially Misdiagnosed as Chronic Eosinophilic Leukemia

Affiliations
  • 1Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea. JungWonH@ewha.ac.kr
  • 2Department of Pathology, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 3Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

Abstract

We report a patient with massive eosinophilia and a complex karyotype that was initially misdiagnosed as chronic eosinophilic leukemia (CEL), but later diagnosed as anaplastic large cell lymphoma (ALCL) masked by massive eosinophilia. The complex karyotype observed at initial diagnosis remained unchanged later, after the evidence of bone marrow involvement of ALCL was obtained. At diagnosis, genetic aberrations corresponding to metaphase cytogenetics were not identified by interphase fluorescence in situ hybridization, although abnormal results were noted at follow-up. Together, these observations indicate that the complex karyotype at initial work-up has been derived from a low proportion of lymphoma cells with high mitotic ability that were not identified by microscopy, rather than from massive eosinophils. These findings suggest that our patient had ALCL with secondary eosinophilia rather than CEL since initial diagnosis.

Keyword

Hypereosinophilia; Metaphase cytogenetics; Interphase fluorescence in situ hybridization; Anaplastic large cell lymphoma; Chronic eosinophilic leukemia
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