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2006, Número 4

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Acta Pediatr Mex 2006; 27 (4)


Linfoma anaplásico de células grandes ALK+ en niños. Análisis morfológico e inmunohistoquímico

Bornstein-Quevedo L, García-Vázquez FJ, López-Corella E

Idioma: Español
Referencias bibliográficas: 29
Paginas: 176-182
Archivo PDF: 434.08 Kb.


RESUMEN

Antecedentes. La clasificación actual de linfoma anaplásico de células grandes (LACG) y la correlación del inmunofenotipo T o B con la expresión de ALK (anaplasic lymphoma kinase) son motivo de controversia. Aunque los LACG representan el 15% de linfomas en niños, las características morfológicas e inmunohistoquímicas no están bien caracterizadas.
Material y métodos. Se evaluaron todos los casos de linfomas de células grandes registrados en el archivo de patología quirúrgica entre 1980 y 2002. Se seleccionaron los casos con morfología anaplásica y se realizó inmunohistoquímica para identificar los LACG ALK+.
Resultados. Se evaluaron 15 casos, siete fueron ALK-negativos (tres linfomas de Hodgkin y cuatro linfomas difusos de células grandes con inmunofenotipo B). Los ocho pacientes con linfomas ALK-positivos se clasificaron como linfomas anaplásicos de células grandes con inmunofenotipo T/nulo en cinco niños y tres niñas (mediana 8 años). Todos fueron positivos para CD30 y 7 de 8 para antígeno epitelial de membrana. En 2 de 8 se observó positividad exclusivamente citoplasmática para ALK. En 6 de 8 el inmunofenotipo fue T y en dos casos fue nulo.
Conclusiones. Los LACG ALK positivos son frecuentes (53%) entre el grupo de linfomas de células grandes con morfología anaplásica. La mayoría muestra co-expresión de CD30, AEM y marcadores genéricos de células T. La utilización de ALK es de utilidad para identificar un subgrupo de linfomas de células grandes.


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