Primary Cutaneous Alk Positive Anaplastic Large Cell Lymphoma in a Melanoma Patient
Journal: Austin Journal of Cancer and Clinical Research (Vol.2, No. 2)Publication Date: 2015-02-21
Authors : Paolino G; Didona D; Gianno F; Garelli V; Soda G; Cantisani C; Calvieri S; Richetta AG;
Page : 1-3
Keywords : Primary cutaneous anaplastic large cell lymphoma; Melanoma; Radiotherapy; Osteomedullary biopsy; Anaplastic lymphoma kinase; Systemic anaplastic large cell lymphoma;
Abstract
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare subset of CD30+ lymphoproliferative disorder, characterized by the presence of large anaplastic cells, which express CD30, CD2, CD3, CD4, and CD5. A 62 year-old male patient presented to our Institute with a history of a fastgrowing and pinkish-brown asymptomatic cutaneous nodule. His medical past history was positive for a malignant melanoma (MM) of the abdomen (0.7 mm Breslow thickness; pT1a). Histologically the lesion showed a diffuse infiltrate consisting in cohesive sheets of large cells with anaplastic morphology with a kidney-shaped nucleus, also known as hallmark cells. Immunohistochemical studies revealed a CD30 expression, and a positivity to perforin and anaplastic lymphoma kinase (ALK). The laboratory and instrumental investigations were all normal and a final diagnosis of PCALCL was made. The patient showed a good response to radiotherapy. Usually PCALCL shares with systemic anaplastic large cell lymphoma (ALCL) the presence of neoplastic CD30+ large T cells, but lack ALK translocations and protein expression. However, the detection of ALK expression in PCALCL should be considered highly suspicious of a cutaneous manifestation of an underlying systemic disease (not detected in our patient). We recommend to exclude a systemic involvement in this kind of disease, with a strict follow-up, especially in patients with double malignancies.
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