Brain Tumor Res Treat.  2017 Apr;5(1):45-48. 10.14791/btrt.2017.5.1.45.

Cutaneous Anaplastic Large T-Cell Lymphoma with Invasion of the Central Nervous System: A Case Report

• Seo HN
• Seo JH
• Lee CY
• Song J
• Kim JH
• Kim HW

• KMID: 2378306
• DOI: http://doi.org/10.14791/btrt.2017.5.1.45

Abstract

Anaplastic large T-cell lymphoma (ALCL) encompasses different clinical entities that can be aggressive or localized. Scalp anaplastic lymphoma kinase (ALK)-negative ALCL is considered a localized lymphoma, and usually extends to the regional lymph nodes; intracranial invasion is rare. A 74-year-old woman was diagnosed with scalp ALK-negative ALCL, but did not exhibit invasion of the lymph nodes. Computed tomography and magnetic resonance imaging revealed intracranial masses with bony erosions. We treated the patient using CHOP chemotherapy and achieved short-term regression of the scalp and intracranial lesions. However, the patients ultimately died of pneumonia during the pancytopenic period. Therefore, caution must be exercised when treating scalp ALK-negative ALCL with intracranial invasion.

Keyword

Lymphoma; Meningioma; Neurofibromatosis

MeSH Terms

Aged
Central Nervous System*
Drug Therapy
Female
Humans
Lymph Nodes
Lymphoma
Lymphoma, T-Cell*
Magnetic Resonance Imaging
Meningioma
Neurofibromatoses
Phosphotransferases
Pneumonia
Scalp
T-Lymphocytes*
Phosphotransferases

Figure

• 

  Fig. 1 Computed tomography findings. A: Non-enhanced brain computed tomography reveals multiple scalp and intracranial masses at the right frontal lobe. B: Enhanced brain computed tomography reveals homogenous well-enhanced lesions that appeared similar to multiple meningioma. C: Computed tomography reveals bony erosions at the right frontal area. D: T2-weighted magnetic resonance imaging reveals edema in the right parietal lobe. E: T1-weighted magnetic resonance imaging reveals central necrosis in the right scalp lesion.

• 

  Fig. 2 The pathological findings were negative for anaplastic lymphoma kinase (×400) (A), positive for CD20 (×400) (B), positive for CD30 (×400) (C), positive for CD79a (×400) (D), positive for CD138 (×400) (E), and positive after hematoxylin and eosin staining (×400) (F).

• 

  Fig. 3 Non-enhanced brain computed tomography reveals regression of the scalp lesion and intracranial lesion after 2 weeks of chemotherapy.

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