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This article discusses a case of a 64-year-old man who presented with back pain and cough. Imaging revealed masses in the chest and abdomen, as well as pleural effusions. Pathological examination of the tissue revealed a poorly differentiated malignant neoplasm that initially appeared to be anaplastic large-cell lymphoma (ALCL) based on immunohistochemical staining. However, further molecular testing confirmed a diagnosis of ALK-rearranged lung adenocarcinoma. The patient has responded to ALK-inhibitor therapy. The article emphasizes the importance of careful interpretation of immunohistochemical stains in cases of poorly differentiated ALK+/CD30+ neoplasms. [Extracted from the article]