A Case Of ALK-positive Anaplastic Large Cell Lymphoma With Lymph Node Metastasis From Thyroid Cancer With Leukemoid Reaction As The Initial Presentation And Literature Review

Objective:To summarize the clinical characteristics,diagnosis,treat ment and related progress of ALK-positive anaplastic large cell lympho ma with leukemoid reaction as starting performance,and against the me rged lymph node metastasis of thyroid carcinoma of this special circums tances,specific analysis the incidence of multiple primary malignant tu mor,clinical characteristics,diagnosis,treatment and prognosis.Methods:A case of leukemoid reaction as the first manifestation of ALK-po sitive anaplastic large cell lymphoma with lymph node metastasis from t hyroid cancer was retrospectively analyzed,and relevant literature was r eviewed.Results:53-year-old women was hospitalized for 8 days because of fever an d cough.The anti-infective therapy was not effective,and there were pr ogressive elevation of white blood cells,systemic edema,multiple lymp h node enlargement,respiratory failure.ALK-positive anaplastic large cell lymphoma with lymph node metastasis from thyroid cancer was diagno sed by systemic PET-CT,lymph node pathology,bone marrow flow cyt ometry and so on.EPOCH regimen has been given for 7 courses of ch emotherapy after reducing tumor load,ventilation assisted by ventilator,continuous hemofiltration and symptomatic support.PET-CT showed that there was no significant hypermetabolism in bone marrow cavity and ly mph node of the whole body.After thyroid cancer surgery,there was no significant hypermetabolism on PET-CT and complete remission was ass essed.Conclusions:Leukemoid reaction is a paraneoplastic syndrome of ALK-positive a naplastic large cell lymphoma.The clinical process of ALK-positive ana plastic large cell lymphoma with leukemoid reaction is highly invasive.The clinical manifestations are easily confused with infectious diseases.C linicians should attach great importance to it.At the same time,we sho uld pay attention to improving the understanding of multiple primary m alignant tumors and avoid missed diagnosis,so as to select a reasonable individualized treatment program.