Anaplastic large cell lymphoma with cavernous sinus syndrome as first symptom

Abstract

Objective A retrospective analysis of the clinical and pathological features of an anaplastic large cell lymphoma (ALCL) with cavernous sinus syndrome as its first symptom. Methods and Results A 35-year-old woman had head and facial pain for a month, diplopia for 7 d, right eyelid drooped for 4 d. Head MRI showed abnormal signals in right cavernous sinus, and pituitary adenoma or carvernous sinus syndrome were considered. Partial tumor resection was performed after hormone therapy was failed. Histological manifestations revealed that the tumor cells were diffuse and heterogeneous with abundant and pink stained cytoplasm, round, oval, irregular or kidney-shaped nuclei. Immunohistochemical staining showed that CD30 and CD56 were positive on the membrane, and epithelial membrane antigen (EMA) was positive on membrane and cytoplasm, and anaplastic lymphoma kinase (ALK) was negative. Ki-67 labeling index was 80%. Unfortunately, this patient died 3 weeks later after the operation, because of severe illness and intolerance to radiotherapy and chemotherapy. Conclusions The diagnosis of ALCL should be considered when cavernous sinus syndrome as the clinical symptom, and pathological examination should be performed if necessary. It should be differentiated from some tumors, such as undifferentiated non-keratinizing nasopharyngeal carcinoma, germinoma, plasmablastic lymphoma, malignant melanoma and Hodgkin's lymphoma (HL).

DOI:10.3969/j.issn.1672-6731.2019.09.014