Primary Cutaneous Anaplastic Large Cell Lymphoma: A Case Report

수부 및 상지의 피부에 발생한 원발성 피부 무형성 대세포 림프종 증례보고 1례

  • Yoo, Jung Seok (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Lee, Dong Lark (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Lim, Jun Kyu (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Yoon, In Mo (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Lee, Byung Du (Department of Pathology, Hanil General Hospital) ;
  • Lee, Dong Eun (EUN Plastic Surgery Clinic)
  • Received : 2006.05.19
  • Published : 2006.11.10

Abstract

Purpose: Anaplastic large cell lymphoma, has the following three characteristics of a malignant lymphoma; 1) An irregular large nucleus, called pathologic atypical cells, 2) Eosinophilic cytoplasm, 3) Immunologically positive for Ki-1. Anaplastic large cell lymphoma occurs mostly in the lymph nodes, but about 40% has been observed to occur in other tissues. Skin is the one of the main sources of origin and it is called 'primary cutaneous anaplastic large cell lymphoma'. Methods: A 69-year-old male patient with an erythematous nodule, sized $1.5{\times}1.7cm$ on his right hand dorsum was excised under local anesthesia and on biopsy was diagnosed as 'Dermatofibrosarcoma Protuberans'. Three months after the local excision and biopsy, same natured mass reoccurred in the same region, and then spontaneous regressed after three weeks. However, metastatic large mass of $4.0{\times}5.0cm$, of same nature was observed on the elbow. The large mass was operated with wide excision and biopsy. Results: On final diagnosis, with an immunofluorescent stain with CD30(Ki-1), 'Primary cutaneous large cell lymphoma' was made. After follow up for three years, we did not observed recurrence and metastasis. Conclusion: We have reported that we have diagnosed primary cutaneous large cell lymphoma and treated without recurrence and metastasis.

Keywords

References

  1. Sagaert X, De Wolf-Peeters C: Anaplastic large cell lymphoma. Current Diagnostic Pathology 9: 252, 2003 https://doi.org/10.1016/S0968-6053(03)00035-8
  2. Liu HL, Hoppe RT, Kohler S, Harvell JD, Reddy S, Kim YH: CD30+ cutaneous lymphoproliferative disorder: The stanford experience in lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma. J Am Acad Dermatol 49: 1049, 2003 https://doi.org/10.1016/S0190-9622(03)02484-8
  3. Stein H, Mason DY, Gerdes J, O'Connor N, Wainscoat J, Pallesen G, Gatter K, Falini B, Delsol G, Lemke H, Schwarting R, Lennert K: The expression of the Hodgikin's disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: Evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells. Blood 66: 848, 1985
  4. Tomaszewki MM, Moad JC, Lupton GP: Primary cutaneous Ki-1(CD30) positive anaplastic large cell lymphoma in childhood. J Am Acad Dermatol 40: 857, 1999 https://doi.org/10.1053/jd.1999.v40.a95960
  5. Shehan JM, Kalaaji AN, Markovic SN, Ahmed I: Management of multifocal primary cutaneous CD30+ anaplastic large cell lymphoma. J Am Acad Dermatol 51: 103, 2004 https://doi.org/10.1016/j.jaad.2003.12.028
  6. Goyal S, Brinster NK, Goyal S: Ki-1(CD30) positive anaplastic large cell lymphoma: Primary nodal disease relapsing as erythroderma. J Am Acad Dermatol 47: S201, 2002 https://doi.org/10.1067/mjd.2002.110668
  7. Lee EJ, Kim H, Seo YJ, Suhr KB, Lee JH, Park JK, Kim YC, Jin CY: A case of primary cutaneous CD30+/ALK-anaplastic large cell lymphoma. Korean J Dermatol 41: 666, 2003
  8. Pulford K, Lamant L, Morris SW, Butler LH, Wood KM, Stroud D, Delsol G, Mason DY: Detection of anaplastic lymphoma kinase(ALK) and nucleolar protein nucleophosmin( NPM)-ALK proteins in normal and neoplastic cells with the monoclonal antibody ALK1. Blood 89: 1394, 1997