A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma with Extensive Inflammatory Cell Infiltration

Abstract

Primary cutaneous anaplastic large cell lymphoma (ALCL) is composed of large cells with anaplastic, pleomorphic cytomorphology and the expression of the CD30 antigen by the majority (more than 75%) of tumor cells. Recently some variants of ALCL with extensive inflammatory cell infiltration have been reported. A 34-year-old male presented with multiple tumors over the arm, groin, and legs. The tumors of the right groin showed ulceration and purulent discharge. The biopsy specimens revealed extensive infiltrate of large atypical lymphoid cells with mixed inflammatory cells consisting of numerous eosinophils and neutrophils. Immunohistochemical staining was positive for CD3, CD4, and CD30. TCR-gamma gene rearrangement was detected. There was no evidence of extracutaneous involvement. We report a case of primary cutaneous ALCL, associated with marked inflammatory cell infiltration. Diagnosis in such cases is challenging because the large atypical lymphoid cells may be easily obscured by the massive infiltrate of eosinophils and neutrophils.