Korean J Dermatol.  2009 Jan;47(1):84-88.

A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma Mimmicking Keratoacanthoma

• Kim ST
• Baek JW
• Kim TK
• Lee JW
• Roh HJ
• Jeon YS
• Suh KS

Abstract

Pseudoepitheliomatous hyperplasia with a massive neutrophil infiltrate associated with primary cutaneous anaplastic large cell lymphoma has been rarely reported. Herein we report on a 33-year-old man who presented with multiple asymptomatic erythematous walnut-sized rapidly growing tumors on the axilla, trunk and left inguinal area for 1 month. The histopathologic features showed a keratoacanthoma-like epithelial hyperplasia in the epidermis and several large atypical lymphoid cells with nuclear plemorphism and abundant cytoplasm in the dermis. The atypical cells were obscured by a rich infiltrate of neutrophils and some eosionophils. Immunohistochemical studies confirmed the majority of the large anaplastic cells in the dermis were CD30+ cells. In addition, the expressions of anaplastic lymphoma kinase (ALK) and epithelial membrane antigen (EMA) were negative. There was no evidence of extracutaneous involvement. The patient was diagnosed with primary cutaneous anaplastic large cell lymphoma (ALCL) and he was treated with low dose methotrexate (15 mg/week). We think that this case was challenging both clinically and histologically.

Keyword

Anaplastic large cell lymphoma (ALCL); CD30; Pseudoepitheliomatous hyperplasia

MeSH Terms

Adult
Axilla
Cytoplasm
Dermis
Epidermis
Humans
Hyperplasia
Keratoacanthoma
Lymphocytes
Lymphoma
Lymphoma, Primary Cutaneous Anaplastic Large Cell
Methotrexate
Mucin-1
Neutrophils
Phosphotransferases
Receptor Protein-Tyrosine Kinases
Methotrexate
Mucin-1
Phosphotransferases
Receptor Protein-Tyrosine Kinases