J Korean Foot Ankle Soc.  2023 Sep;27(3):108-111. 10.14193/jkfas.2023.27.3.108.

Anaplastic Large Cell Lymphoma Mimicking a Muscle Abscess: A Case Report

• Baek J
• Kim Y
• Lee W
• Yoon YK
• Lee JW
• Shim DW

• KMID: 2545990
• DOI: http://doi.org/10.14193/jkfas.2023.27.3.108

Abstract

Anaplastic large cell lymphoma (ALCLs) are a group CD30-positive mature T-cell lymphomas, an uncommon subtype of non-Hodgkin lymphomas, characterized by diverse clinical and genetic features. Among the types of ALCL, anaplastic lymphoma kinase (ALK)-negative ALCL, though typically involves the lymph nodes, can infrequently invade other tissues. When soft tissue involvement occurs, it may mimic the clinical presentation of infectious diseases, leading to potential misdiagnosis. Therefore, a histological examination is necessary to differentiate between ALK-negative ALCL and similar phenotypes associated with infectious conditions. This paper reports a case of ALCL, initially misdiagnosed as an infection.

Keyword

Lymphoma; large-cell; anaplastic; Infections

Figure

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  Figure 1 Initial clinical photograph of right foot ankle with redness and swelling.

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  Figure 2 Preoperative image studies. (A, B) Sagittal magnetic resonance imaging of right ankle shows mass-like lesion along extensor tendons of ankle (arrows) preserving ankle joint. (C) Axial magnetic resonance imaging of lower leg shows mass-like lesion extending to distal tibia and involving interosseous membrane posteriorly (arrow).

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  Figure 3 Soft tissue pathology of right lower leg shows anaplastic large cell lymphoma, anaplastic lymphoma kinase (ALK)-negative. (A) Hematoxylin and Eosin staining shows large anaplastic cells (H&E, ×100). (B) CD30 immunostaining shows CD30-positive (×20). (C) ALK immunostaining shows ALK-negative (H&E, ×20).

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  Figure 4 Postoperative image studies. Positron emission tomography shows intense F-fluorodeoxyglucose uptake in the right lower leg and ankle (arrow).

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