Abstract
Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare non-Hodgkin lymphoma subtype that predominantly affects the skin. This condition involves the abnormal proliferation of T-cells expressing the CD30 antigen. We report the case of a 70-year-old male with no history of malignancy who presented with a right foot lesion consistent with primary cutaneous anaplastic large cell lymphoma.
The lesion had been present for one year, initially appearing as redness near the lateral ankle and spreading towards the toes, accompanied by a burning sensation. The patient reported fatigue and night sweats but denied fever, chills, or other symptoms. Upon physical examination, an 8x4 cm violaceous plaque was observed on the right dorsolateral foot, extending to the midfoot. The plaque partially showed poorly defined borders. No palpable lymphadenopathy was detected.
Microscopic examination revealed a population of large, anaplastic, pleomorphic lymphoid cells exhibiting a prominent angiocentric pattern. The tumor cells stained positive for CD3, CD4, and CD30, with loss of CD5 and CD7 expression. CD8, CD56, CD21, BCL6, CD10, CXCL13, ALK-1, and EBV were negative. The Ki67 proliferative index was 50%. T cell gene rearrangement studies identified clonal T-cell receptor γ and β chain gene rearrangements.
These findings are consistent with cutaneous ALK- anaplastic large cell lymphoma exhibiting an angioinvasive growth pattern. To our knowledge, very few case reports in the literature describe this rare presentation of anaplastic large cell lymphoma. This case report highlights an unusual pathological manifestation this lymphoma.