# Anaplastic Large Cell Lymphoma (ALCL) With a Sarcomatoid Variant Presenting As Distributive Shock in a 41-Year-Old Female: A Case Report

## TL;DR

A rare case of anaplastic large cell lymphoma with a sarcomatoid variant presented as distributive shock in a diabetic woman.

## Contribution

This case report highlights the rare presentation of ALCL with a sarcomatoid variant mimicking septic shock.

## Key findings

- The patient presented with distributive shock and was found to have ALCL with a sarcomatoid variant.
- Biopsy confirmed the presence of malignant anaplastic lymphoma cells with a sarcomatous variant.
- The patient's family chose comfort care over chemotherapy despite oncology recommendations.

## Abstract

The sarcomatoid variant is considered a rare subtype of anaplastic large cell lymphoma. We present a 40-year-old diabetic female who was evaluated in the ER for distributive shock, requiring vasopressors and mechanical ventilation. An extensive workup was negative for infection. A serial CT scan of the abdomen and pelvis showed evolving lymphadenopathy, and a biopsy revealed malignant anaplastic lymphoma cells with a sarcomatous variant. The oncology team recommended the initiation of inpatient chemotherapy; however, the family opted to proceed with comfort care measures.