Primary cutaneous anaplastic large-cell lymphoma with DUSP22-IRF4 rearrangement following insect bites

Primary Cutaneous Anaplastic Large Cell Lymphoma With Rare Extracutaneous Disseminated Disease: A Case Report

ABSTRACT

Primary cutaneous anaplastic large cell lymphoma (pcALCL) is a CD30 + lymphoproliferative disorder with generally favorable outcomes and infrequent extracutaneous spread, usually limited to local lymph nodes. However, there may be extensive histologic overlap with more aggressive CD30 + lymphomas, such as large cell transformation of mycosis fungoides or secondary skin involvement by anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma. Definitive diagnosis relies on clinicopathologic correlation. We report on a 26-year-old woman who presented to our institution with progressive lower extremity wounds for several months, previously treated with antibiotics and vacuum-assisted closure dressings. Consultation with dermatology and 2 separate biopsies eventually led to the diagnosis of pcALCL. Subsequent imaging revealed stage IV disease with innumerable intensely fluorodeoxyglucose (FDG)-avid subcutaneous, intramuscular, and visceral foci, but paucity of lymph node involvement. The patient's condition deteriorated, and she died during her hospitalization. This case reviews the clinicopathologic findings of pcALCL, emphasizes the importance of clinicopathologic correlation in differentiating between CD30 + lymphoproliferative disorders, highlights the extremely rare phenomenon of systemic intramuscular and visceral disseminated disease occurring in pcALCL, and discusses implications for prognosis.

CD30 in Cutaneous Pathology

ABSTRACT

The discovery of CD30 as a diagnostic marker was essential in the identification of not only some lymphomas but also many other solid tumors and benign reactive conditions. Many CD30+ cutaneous disorders and tumors have been categorized since the identification of the marker. With the design of targeted therapies against CD30+ tumoral cells, the interest in CD30 determination was not only diagnostic but also mainly therapeutic. In this article, we explore the historical aspects of the discovery of CD30 and examine the main CD30-related cutaneous pathology, susceptible of anti-CD30 modern treatments.

A Case of Anaplastic Large Cell Lymphoma Misdiagnosed with Keloid

We report a case of a patient initially diagnosed with keloid and eventually diagnosed by skin histopathology and immunohistochemistry with primary cutaneous ALK-negative anaplastic large cell lymphoma.