Primary ALK-positive anaplastic large cell lymphoma of the urinary bladder in a pediatric patient: a case report and review of literature.
Navdeep Kaur, Akhila Aravind, Sarika P Jain
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Case in brief
A 14-year-old male presented with several months of gross hematuria that became painful. Imaging revealed a mass-like thickening of the anterior bladder wall, and cystoscopy identified a 3.5-cm pedunculated lesion. Histological analysis confirmed ALK-positive anaplastic large cell lymphoma (ALCL). Following multi-agent chemotherapy, the patient showed initial improvement, but later developed recurrent hematuria with biopsies revealing no lymphoma. He continues to be monitored.
What made this case unusual
This case highlights the rarity of primary ALK-positive ALCL in the urinary bladder of a pediatric patient, contrasting with the typical adult presentation.
Diagnostic / clinical pearl
Key diagnostic features of ALK-positive ALCL include uniform CD30 positivity and ALK immunostaining, which are critical for accurate identification in atypical presentations.
Why it matters
Understanding the presentation and diagnostic markers of rare lymphomas like ALK-positive ALCL in children can aid in timely diagnosis and management, preventing misdiagnosis.