Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2857-2863
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2857
ALK-positive anaplastic large cell lymphoma of the thoracic spine occurring in pregnancy: A case report
Sen Yang, Wei-Min Jiang, Hui-Lin Yang
Sen Yang, Wei-Min Jiang, Hui-Lin Yang, Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: Yang S, Jiang WM and Yang HL participated in the diagnosis and management of this case; Yang S and Jiang WM joined the surgery; Yang S wrote the manuscript; Jiang WM and Yang HL revised the manuscript; all authors read and approved the final manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to CARE checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wei-Min Jiang, MD, PhD, Doctor, Full Professor, Surgeon, Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China. jwmspine@126.com
Telephone: +86-13004502480
Received: June 15, 2019
Peer-review started: June 19, 2019
First decision: August 2, 2019
Revised: August 6, 2019
Accepted: August 27, 2019
Article in press: August 26, 2019
Published online: September 26, 2019
Abstract
BACKGROUND

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin’s lymphoma (NHL). ALCL is rare as a bone lesion and in pregnancy.

CASE SUMMARY

We present the first case of anaplastic lymphoma kinase (ALK)+ ALCL of the thoracic spine during pregnancy. A 25-year-old pregnant woman was presented to us at 24 wk’ gestation with severe back pain and weakness in the left lower limb. Imaging examination showed lesions at T10 and T11. She underwent posterior pedicle screw fixation and vertebroplasty. Pathological examination showed ALK+ ALCL. The patient chose to have therapeutic abortion after surgery and received chemotherapy in the hematology department. She now remains disease free with no neurological deficit after 30 mo’ follow-up.

CONCLUSION

ALK+ ALCL with the thoracic spine involvement is uncommon, especially in pregnancy. Many symptoms can be misunderstood during pregnancy; therefore, when a pregnant patient has persistent back pain or lower limb neurological symptoms, imaging examinations should be performed.

Keywords: Anaplastic large cell lymphoma, Pregnancy, Thoracic spine, Surgical treatment, Chemotherapy, Case report

Core tip: We present the first case of anaplastic lymphoma kinase anaplastic large cell lymphoma of the thoracic spine during pregnancy. The patient underwent posterior spinal cord decompression and pedicle screw fixation surgery and chemotherapy. There were major improvements in the patient's status. We concluded that it is important to have a detailed examination of pregnant women with back pain and neurological deficits.