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FINAL DIAGNOSIS

LARGE CELL ANAPLASIC LYMPHOMA

COMMENTS ON PATHOLOGIC FINDINGS
Immunohistochemical techniques definitvely diagnose the malignant proliferation.

CD30 antigen can diferentiate between Hodgkin's disease (CD30-) and anapastic no-Hodgkin's lymphomas (CD30+) EMA antigen is never shown on Hogkin's cells (EMA-)

Regarding the proliferation of large malignant lymphoid cells with positive stain for the CD30 and the EMA antigens, it is an anapastic lymphoma.

COULD THE BAL SAMPLE BE ABLE TO DO THE DIAGNOSIS?

— no
— to R/O diferential diagnosis?

– infections
– oportunistic infection (AIDS?) PCP, Herpes V Joshi et al. Hum pathol 1985

Even no evidence of immunodeficiency, decreased cellular immunity can preceed Tx in several malignacies, notably H lymphoma, NH lymphomas and leukemia.
Wood et al. J Infect Dis 1985

— non specific feature-alveolitis with increase lymphocytic level

POST-OPERATIVE COURSE

A small pneumothorax was noted in subsequent lung biopsy and improved completely with tube. The patient benefited form a rapid chemotherapy and respiratory distress improved dramatically in the first days of treatment. However, she had central nervous system and peripheral involvement by the lymphoma. There deterioration in other organs and she developped an acute respiratory distress syndrome that is presently resolving.


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