Anaplastic large cell lymphoma encircling right brachial plexus

Case contributed by Dr Domagoj Kretic

Presentation

40 year old male felt pain in his right shoulder after doing his regular series of push-ups. Some radial nerve palsy was detected by orthopaedist who recommended shoulder US.

Patient Data

Age: 40
Gender: Male

Large lobulated hypoechogenic mass in right subpectoral region, together with muscle oedema and enlarged lymph nodes.

CT after administrated contrast in arterial phase is showing large lesion in right subpectoral area encircling right subclavian artery. Artery is somewhat compressed but clearly without significant stenosis or occlusion.

Lymphadenopathy is seen in right axillary region.

MRI sequences show large heterogenous, lobulated mass , with dimensions 10,5 x 9,5 x 11 cm.

Mass is encircling subclavian artery and right brachial plexus.

There is significant intermuscular and soft tissue oedema, together with lymphadenopathy.

Case Discussion

After US findings with large mass in right subpectoral region, MRI was performed and showed large lobulated heterogenous mass encircling right subclavian artery and brachial plexus.

FNAC was performed with result of PNET, after noticing fast growth and on-going progression of symptoms, radical cervicosternothoracotomy was performed with removing mass , brachial plexus and subclavian artery, which was replaced with PTFE graft.

Histopathology result was ALK+ ALCL, or anaplastic lymphoma kinase positive anaplastic large cell lymphoma.

 

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Case information

rID: 26947
Case created: 15th Jan 2014
Last edited: 27th Sep 2015
Inclusion in quiz mode: Included

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