The patient had a
history of nodal anaplastic large cell lymphoma (ALCL). The bone
biopsy revealed lymphoma involvement.
ALCL in marrow can be
subtle and only show focal interstitial or sinusoidal infiltration
without obvious marrow architecture destruction. Therefore,
special attention should be paid in staging ALCL in bone marrow
biopsy, and immunostains with CD30 and ALK, if positive
in primary tumor, are very helpful.