CD30+ Anaplastic Large-cell Lymphoma with Aberrant Expression of CD13: Case Report and Review of the Literature

CD13 is commonly expressed in hematopoietic malignancies of myelomonocytic origin and has less commonly been described in lymphoid neoplasms, including acute lymphoblastic leukemia, B-cell lymphoproliferative disorders, and plasma cell malignancies. Aberrant CD13 expression has rarely been described in KP-1 (CD68)-positive large-cell lymphomas. However, CD13 positivity has not previously been described in a case of CD30+ (ALK-1+) anaplastic large-cell lymphoma of presumed null-cell origin without histiocytic differentiation. The purpose of this case report is to describe a CD30+ anaplastic large-cell lymphoma of presumed null-cell origin with aberrant expression of CD13. The case illustrates the unique usefulness of immunophenotypic and molecular techniques in establishing the correct diagnosis. The case was referred with a diagnosis of "rule out granulocytic sarcoma versus megakaryocytic malignancy" due to the morphology and a limited flow cytometric immunophenotypic (FCI) panel that had been performed and revealed expression of CD45, HLA-DR, and CD13. Subsequent morphologic review at our institution combined with an expanded FCI panel established the diagnosis. The differential diagnosis of a CD13+ hematopoietic malignancy should include this entity. The prognostic significance of this finding has yet to be determined.