# Anaplastic lymphoma kinase-positive large B-cell lymphoma misdiagnosed as multiple myeloma: a case report and literature review

## TL;DR

A rare case of ALK-positive large B-cell lymphoma was initially misdiagnosed as multiple myeloma and later treated with a combination of therapies.

## Contribution

This case highlights the diagnostic challenges and treatment approach for ALK+ LBCL mimicking multiple myeloma.

## Key findings

- The patient initially responded to VRD chemotherapy but relapsed after discontinuation.
- Diagnosis was confirmed as ALK+ LBCL after surgery and subsequent treatment with ALK inhibitors and CHOP.
- Combination therapy with ALK inhibitors, CHOP, and daratumumab led to a brief remission.

## Abstract

间变性淋巴瘤激酶阳性大B细胞淋巴瘤（ALK+ LBCL）临床罕见，其浆母细胞分化、结外骨及骨髓受累表现少见，患者常规化疗敏感性低、预后差。本文回顾性分析临沂市中心医院收治的1例以骨质破坏及骨髓受累为主要表现被误诊为多发性骨髓瘤的ALK+ LBCL患者的诊治过程并进行相关文献复习。患者为64岁男性，因咳嗽、咳痰伴胸背部疼痛半月入院，被诊断为多发性骨髓瘤，接受VRD方案化疗3个疗程后被评估为部分缓解。患者自行停药2个月后出现截瘫，经胸椎内占位切除病理诊断ALK+ LBCL，给予ALK抑制剂联合CHOP方案化疗3个疗程，加用达雷妥尤单抗2个疗程后短暂缓解。