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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0044-1796637
Case Report with Review of Literature

An Isolated Cutaneous Relapse in a Known Case of Systemic ALK-Positive Anaplastic Large Cell Lymphoma: A Rare Case Report with Review of Literature

Monisha Shetty
1   Department of Dermatology, Venereology and Leprosy, K. S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India
,
Banavasi Shanmukha Girisha 
1   Department of Dermatology, Venereology and Leprosy, K. S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India
,
Sona C. Gowda
1   Department of Dermatology, Venereology and Leprosy, K. S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India
,
Vijith Shetty
2   Department of Medical Oncology, K. S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, Karnataka, India
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Abstract

Among non-Hodgkin's lymphomas (NHLs), anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a relatively uncommon subtype that accounts for 3% of all adult NHLs. It typically affects young males, with a prevalence of three to one. Most cases present with nodal disease at the time of presentation. An extranodal involvement is seen in 60% of cases and skin involvement is seen in only 8 to 21% of cases. Cutaneous involvement in ALCL can manifest as primary cutaneous ALCL or secondary to systemic ALCL, and while CD30 positivity is common to both, ALK is not expressed by the former. A secondary skin involvement is usually associated with a poorer prognosis.

We report a rare case of an isolated cutaneous relapse of systemic ALK-positive ALCL in a 62-year-old woman following the second cycle of chemotherapy. The acute febrile, widespread papulonodular eruption clinically resembled mycosis fungoides and lymphomatoid papulosis. With the introduction of oral crizotinib, a drastic improvement in the skin lesions and an exceptional response on positron emission tomography-computed tomography were noted.

Keywords

ALCL - ALK-positive anaplastic large cell lymphoma - ALK-positive ALCL - cutaneous metastasis - crizotinib

Declaration of the Patient Consent form

Written informed consent was obtained from all the patients and/or guardians.




Publication History

Article published online:
26 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Tsuyama N, Sakamoto K, Sakata S, Dobashi A, Takeuchi K. Anaplastic large cell lymphoma: pathology, genetics, and clinical aspects. J Clin Exp Hematop 2017; 57 (03) 120-142
    CrossrefPubMedSearch in Google Scholar
  • 2 Oschlies I, Lisfeld J, Lamant L. et al. ALK-positive anaplastic large cell lymphoma limited to the skin: clinical, histopathological and molecular analysis of 6 pediatric cases. A report from the ALCL99 study. Haematologica 2013; 98 (01) 50-56
    CrossrefPubMedSearch in Google Scholar
  • 3 Stein H, Mason DY, Gerdes J. et al. The expression of the Hodgkin'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 1985; 66 (04) 848-858
    CrossrefPubMedSearch in Google Scholar
  • 4 Alaggio R, Amador C, Anagnostopoulos I. et al. The 5th Edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms [published correction appears in Leukemia. 2023; 37(9): 1944–1951]. Leukemia 2022; 36 (07) 1720-1748
    CrossrefPubMedSearch in Google Scholar
  • 5 Ferreri AJ, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-positive. Crit Rev Oncol Hematol 2012; 83 (02) 293-302
    CrossrefPubMedSearch in Google Scholar
  • 6 Jacobsen E. Anaplastic large-cell lymphoma, T-/null-cell type. Oncologist 2006; 11 (07) 831-840
    CrossrefPubMedSearch in Google Scholar
  • 7 Hapgood G, Savage KJ. The biology and management of systemic anaplastic large cell lymphoma. Blood 2015; 126 (01) 17-25
    CrossrefPubMedSearch in Google Scholar
  • 8 Campo E, Chott A, Kinney MC. et al. Update on extranodal lymphomas. Conclusions of the Workshop held by the EAHP and the SH in Thessaloniki, Greece. Histopathology 2006; 48 (05) 481-504
    CrossrefPubMedSearch in Google Scholar
  • 9 Kadin ME, Carpenter C. Systemic and primary cutaneous anaplastic large cell lymphomas. Semin Hematol 2003; 40 (03) 244-256
    CrossrefPubMedSearch in Google Scholar
  • 10 Kempf W. CD30+ lymphoproliferative disorders: histopathology, differential diagnosis, new variants, and simulators. J Cutan Pathol 2006; 33 (Suppl. 01) 58-70
    CrossrefPubMedSearch in Google Scholar
  • 11 Martinez-Cabriales SA, Walsh S, Sade S, Shear NH. Lymphomatoid papulosis: an update and review. J Eur Acad Dermatol Venereol 2020; 34 (01) 59-73
    CrossrefPubMedSearch in Google Scholar
  • 12 Kempf W, Pfaltz K, Vermeer MH. et al. EORTC, ISCL, and USCLC consensus recommendations for the treatment of primary cutaneous CD30-positive lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Blood 2011; 118 (15) 4024-4035
    CrossrefPubMedSearch in Google Scholar
  • 13 Mendiratta V, Gandhi N, Rana S, Shukla S. Ramchander. Isolated cutaneous involvement in a child with nodal anaplastic large cell lymphoma. Indian J Dermatol Venereol Leprol 2016; 82 (01) 53-56
    CrossrefPubMedSearch in Google Scholar
  • 14 Murkute AS, Damle DK, Doshi BR, Belgaumkar VA. Systemic anaplastic large cell lymphoma with secondary cutaneous involvement. Indian J Dermatol Venereol Leprol 2015; 81 (02) 208-210
    CrossrefPubMedSearch in Google Scholar