Fine Needle Aspiration Cytology of Small Cell Variant of Anaplastic Large Cell Lymphoma: A Case Report

BACKGROUND: Small cell variant of anaplastic large cell lymphoma (ALCL) is a rare and still underrecognized variant of ALCL. In contrast to the classic type of ALCL, which is sometimes mistaken for carcinoma or sarcoma, the small cell variant may be misdiagnosed as a reactive lesion without a high index of suspicion. CASE: We present a case of small cell variant of ALCL occurring in a 14-year-old female. It posed great difficulty in the fine needle aspiration (FNA) diagnosis due to the rarity of large, atypical cells. A subsequent lymph node biopsy demonstrated the typical histologic and immunophenotypic findings of the small cell variant of ALCL. CONCLUSION: This case indicates that small cell variant of ALCL should always be considered in the FNA diagnosis of unusual-looking, heterogeneous lymphoid proliferations dominated by atypical small or medium-sized lymphoid cells, particularly in young patients.