ALK-positive large B-cell lymphoma

ICD-O-3 Morphology

9737/3: ALK-positive large B-cell lymphoma
Effective 2010 and later


for cases diagnosed 2010 and later

Primary Site(s)

See Module 7
Most common sites of involvement: lymph nodes, mediastinal mass, nasopharynx, tongue, stomach, bone and soft tissues.

Abstractor Notes

(This code is effective for cases diagnosed 2010 and later. For cases diagnosed prior to 2010, see code 9684/3.)

Most patients present with Stage III/IV. Because these tumors are negative for CD20 antigen, they are insensitive to rituximab.

Diagnostic Confirmation

This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.


Not Applicable

Module Rule


Alternate Names

ALK-positive LBCL
ALK-positive plasmablastic B-cell lymphoma [OBS]
Large B-cell lymphoma expressing the ALK kinase and lacking the t(2;5) translocation [OBS]


ALK-positive large B-cell lymphoma (LBCL) is an aggressive neoplasm of ALK-positive monomorphic large immunoblast-like B cells, which usually have a plasma cell phenotype.

Definitive Diagnostic Methods

Genetic testing
Histologic confirmation

Genetics Data

CLTC-ALK fusion gene
Immunoglobulin genes are clonally rearranged
SQSTM1 or SEC31A fusion


ALK protein positive
CD3- (no expression/negative)
CD20- (no expression/negative)
CD30- (no expression/negative)
CD45- (no expression/negative) or weak
CD79a- (no expression/negative)
CD138+ (expression/positive)
CLTC-ALK fusion protein+ (expression/positive)
Cytoplasmic staining with other ALK translocations
IRF4/MUMI+ (expression/positive)
NPM1-ALK fusion protein with nucleolar ALK staining
PAX5- (no expression/negative)
PRDm1 (also known as BLIMP1)
VS38+ (expression/positive)



Transformations to

There are no known transformations

Transformations from

There are no known transformations

Corresponding ICD-9 Codes

200.6 Anaplastic large cell lymphoma

Corresponding ICD-10 Codes

C83.3 Non-Hodgkin lymphoma large cell (diffuse)

Corresponding ICD-10-CM Codes (U.S. only)

C83.3 Diffuse large B-cell lymphoma (effective October 01, 2015)

Signs and Symptoms

Drenching night sweats
Fever (for no known reason)
Mediastinal mass
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
Skin rash or itchy skin
Weight loss (for no known reason)

Diagnostic Exams

Blood chemistry studies
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
PET (positron emission tomography) scan

Progression and Transformation


Epidemiology and Mortality

Age: 36 years median age (9-70 years range)
Incidence: <1% of DLBCL lymphomas
Sex: male predominance
Survival: median survival 11 months; >156 months survival for children


Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 319-320

International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes

National Cancer Institute
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)