Ann Dermatol.  2016 Aug;28(4):491-494. 10.5021/ad.2016.28.4.491.

Synchronous Occurrence of Primary Cutaneous Anaplastic Large Cell Lymphoma and Squamous Cell Carcinoma

• Park JH
• Lee JH
• Lim Y
• Lee YJ
• Lee DY

• KMID: 2344821
• DOI: http://doi.org/10.5021/ad.2016.28.4.491

Abstract

CD30+ lymphoproliferative disorders (LPD) represent a spectrum of T-cell lymphoma including lymphomatoid papulosis and anaplastic large cell lymphoma (ALCL). Epidermis overlying cutaneous CD30+ LPD often shows epidermal hyperplasia, hyperkeratosis, crusting, and ulceration and it is difficult to distinguish from carcinoma such as keratoacanthoma (KA) or squamous cell carcinoma (SCC). Several cases of pseudocarcinomatous hyperplasia mimicking KA or SCC in CD30+ LPD have been reported. The relationship between CD30+ LPD and epithelial proliferations has not yet well understood. It was reported that a variety of mediators, including epidermal growth factor (EGF), transforming growth factor-α and EGFR from CD30+ LPD could attribute to epidermal hyperplasia. However, separate and distinct SCC occurring in CD30+ LPD has rarely been reported. Herein, we present a rare case of coexistence of SCC and cutaneous ALCL located on the same region.

Keyword

CD30; Cutaneous; Lymphoma; Epithelial hyperplasia; Lymphoproliferative disorders; Squamous cell carcinoma

MeSH Terms

Carcinoma, Squamous Cell*
Epidermal Growth Factor
Epidermis
Epithelial Cells*
Hyperplasia
Keratoacanthoma
Lymphoma
Lymphoma, Large-Cell, Anaplastic
Lymphoma, Primary Cutaneous Anaplastic Large Cell*
Lymphoma, T-Cell
Lymphomatoid Papulosis
Lymphoproliferative Disorders
Ulcer
Epidermal Growth Factor

Figure

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  Fig. 1 A 15 mm diameter ulcerative tumor with erythematous plaques and papules on the left forearm.

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  Fig. 2 (A) Histological analysis of the shave biopsy specimen shows exo-endophytic epidermal proliferation with hyperkeratosis, horn cysts, and microabscesses and dense cellular infiltrates in dermis (H&E, ×40). (B) Invasive atypical cells dissecting collagen bundle suggested squamous cell carcinoma (arrows; H&E, ×200). (C) Large atypical cells were obscured by a massive infiltrate of neutrophils and eosinophils in dermis (arrows; H&E, ×200). (D) Large atypical cells are positive for CD30 (CD30, ×200). (E) Expression of Ki-67 was diffuse in epidermis and large cells of dermis. (F) The expression of p53 was diffuse and scattered throughout epidermis.

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