Primary bone anaplastic lymphoma kinase positive anaplastic large-cell lymphoma: A case report and review of the literature

Figure 1 Computed tomography scan of the chest showing an osteolytic lesion in T10 vertebral body (orange arrow).

Figure 2 Thoracic magnetic resonance imaging. A and B: Thoracic enhanced magnetic resonance imaging showed obvious T2 and T10 vertebral bone destruction (orange arrows); C-F: Positron emission tomography-computed tomography showed increased 18F-fluorodeoxyglucose avidity involving the left sphenoid wing, the C4-5, T2, T10, L5, S1, and S5 vertebrae; the right humeral head, both sides of the humerus, and the right proximal femur. Multiple osteolytic lesions were identified as hypermetabolic lesions with a maximum standard uptake value of 18.64; different degrees of bone destruction can be observed in corresponding sites (orange arrows).

Figure 3 Histopathological microphotograph of primary bone anaplastic large-cell lymphoma. A: The lesions of the vertebral body were infiltrated by pleomorphic tumor cells which have scanty cytoplasm and hyperchromatic nuclei (magnification × 100); B: The neoplastic cells exhibited small- to medium-sized, irregular nuclei and abundant clear cytoplasm. Hallmark cells (horseshoe-shaped or doughnut cells) were present and Reed-Sternberg cell-like cell were also noted (magnification × 400); C-F: On immunohistochemistry, the large atypical cells showed positive expression of anaplastic lymphoma kinase (C), CD3 (D), and CD30 (E), and the Ki67 index was almost 60% (F).