Delayed Recognition of Primary Cutaneous Anaplastic Large Cell Lymphoma Mimicking Pyogenic Infection: A Lesson from Primary Care
- Author:
Chu Ee SEOW
;
Nur Izreena ISMAIL
;
Haryati HUSIN
;
Adawiyah JAMIL
;
Mohan ARUMUGAM
;
Chong Guang YONG
;
Nor Rafeah TUMIAN
- Publication Type:Case Report
- Keywords:
Cutaneous malignancy;
Lymphoma;
Delayed diagnosis;
Pyogenic infection I Chu Ee SEOW1*;
Nur Izreena ISMAIL2;
Haryati HUSIN3;
Adawiyah JAMIL2;
Mohan ARUMUGAM2;
Chong Guang YONG4;
Nor Rafeah TUMIAN4
- From:
Brunei International Medical Journal
2025;21():165-169
- CountryBrunei Darussalam
- Language:English
-
Abstract:
Early-stage cutaneous lymphoma often mimics non -malignant skin disorders, leading to common misdiagnoses and delays in appropriate treatment. A 44 -year-old Malay male presented with a progressive ulcerating nodular lesion on his left medial forearm, which had been treated for a pyogenic cutaneous infection with three different courses of oral antibiotics. The patient even attempted selftreatment with traditionally prepared chalk powder. On the fourth visit to the primary care clinic, a referral to the dermatology clinic was made. A biopsy was done, and histopathology and immunohistochemistry studies of the skin lesion were suggestive of anaplastic lymphoma kinase (ALK) negative anaplastic large cell lymphoma (ALCL). Staging of the disease showed that it was limited to an early stage without systemic involvement. The cutaneous lymphoma in this case was successfully treated with radiotherapy after the failure of oral methotrexate. Early recognition of pc -ALCL is important to avoid delayed treatment. This case highlights the need for greater awareness among primary care physicians of unusual but important dermatological disorders, particularly cutaneous malignancies. Misdiagnosis can impair the patient -doctor relationship and reduce patient compliance with treatment.
