1.Primary cutaneous anaplastic large-cell lymphoma with metastases in an 81-year-old Filipino female
Terese Monette O. Aquino ; Ma. Jasmin J. Jamora ; Karla Angela P. Cuenca-Luchangco ; Julia Erika P. Pangasinan
Journal of the Philippine Dermatological Society 2018;27(1):64-67
Introduction:
Primary Cutaneous Anaplastic Large Cell Lymphoma (PC-ALCL) is a rare Non-Hodgkin lymphoma (NHL)
representing approximately 9% of all cutaneous lymphomas.3
It usually manifests as a slow-growing, solitary tumor
which has a tendency to regress spontaneously. However, metastasis is reported in 5-10% of cases.2
Case Summary:
Our case is an 81-year-old female with a four-month history of an enlarging nodule on the left upper
back. The initial impression was a malignant cutaneous tumor. Histopathology revealed epidermotropic large atypical
lymphocytes and diffuse infiltrates of hyperchromatic, pleomorphic mononuclear cells and lymphocytes.
Immunohistochemistry showed CD3+, CD20-, CD30+, epithelial membrane antigen (EMA)- and anaplastic lymphoma
kinase (ALK)- consistent with PC-ALCL. Metastatic work-up revealed pulmonary involvement. The patient underwent
two cycles of multi-agent chemotherapy with marked improvement. However, patient declined further treatment and
expired five months after the diagnosis.
Conclusion
This case emphasizes that although PC-ALCL commonly presents with an indolent course, extracutaneous
spread can occur. Prompt treatment with chemotherapy increases survival significantly with a cure rate of 92%.2
Lymphoma, T-Cell
;
Neoplasms