CASE REPORT article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
This article is part of the Research TopicFrontiers in Cancer Neuroscience: Unraveling the Complex Interplay of Neural Mechanisms in Tumorigenesis and TherapeuticsView all 3 articles
Case report: Cerebellar ALK+ ALCL: Diagnostic Challenges and Therapeutic Innovation
Provisionally accepted
- Second Hospital of Hebei Medical University, Shijiazhuang, China
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Primary anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) of the central nervous system (CNS) is an exceedingly rare T-cell malignancy, with only a few adult cases reported worldwide. To our knowledge, this represents the first reported adult case of cerebellar ALK+ ALCL from China, highlighting both diagnostic challenges and therapeutic innovations in neuro-oncology. We present a 35-year-old male with subacute cerebellar syndrome initially misdiagnosed as infectious encephalitis due to overlapping clinical, radiological, and cerebrospinal fluid (CSF) findings. Progressive neurological deterioration despite empiric antimicrobial therapy prompted histopathological evaluation, which confirmed ALK+ ALCL with a high Ki-67 index (60%). Targeted therapy with the CNS-penetrant ALK inhibitor alectinib 2 induced rapid clinical improvement and significant radiographic regression. This case highlights the diagnostic pitfalls of CNS ALCL, emphasizes the necessity of early biopsy in atypical lesions, and demonstrates the transformative potential of molecularly targeted therapies for rare neuro-oncological malignancies.
Keywords: Anaplastic large cell lymphoma, ALK+, Cerebellar, Ki-67 index, primary cns lymphoma, precision oncology
Received: 30 Apr 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Hao, Wang, Gao and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lan Yang
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