What is anaplastic large cell lymphoma?

Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma (NHL) that develops from white blood cells called T-cells and causes the lymph nodes to swell.

There are four types of ALCL, which have complicated names that are based on their features and proteins. These include:

• ALK-positive ALCL – which is the most common type.
• ALK-negative ALCL – a high-grade lymphoma.
• Breast implant-associated ALCL – that develops very rarely following silicone breast implantation. Despite occurring in the breast, it is not a type of breast cancer.
• Primary cutaneous ALCL – a low-grade T-cell lymphoma that develops in the skin.

What are the symptoms?

The most common sign of ALCL is a painless swelling in the neck, armpit or groin. Other symptoms might include:

• Sweating
• High temperatures and fever
• Unexplained weight loss.

ALCL may also be found outside of the lymph nodes and can cause many different symptoms, for example, if there is lymphoma in the chest, the patient might feel short of breath, develop a cough or feel like there is pressure in their chest.

In cases of breast implant-associated ALCL, there may be a build-up of fluid or a lump around the implant.

How is anaplastic large cell lymphoma diagnosed?

The commonest way to test for ALCL is to remove part or all of an enlarged lymph node, which is known as a biopsy. The lymphoma cells would then be analysed in a laboratory. Further tests, such as blood tests or X-rays may also be required.

How is anaplastic large cell lymphoma treated?

A team of specialists (multidisciplinary team) will determine what is the best possible treatment for your individual case. This will be based on the results of your biopsy and depends on which grade/ stage and type that you have and, for instance, whether you have ALK-positive or ALK-negative.

Those diagnosed with ALCL are likely to be treated with chemotherapy but the number of cycles and type of chemo depends on the age of the patient and their general health. Other treatment options may involve steroids, radiotherapy, stem cell transplants and targeted therapy.