Diagnostic and management challenges in primary cutaneous anaplastic large cell lymphoma with necrosis, inflammation, and surgical intervention: A case report.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL World Journal of Clinical Cases Pub Date : 2024-11-06 DOI:10.12998/wjcc.v12.i31.6486
Jun Mo Kim, Woo Young Choi, Ji Seon Cheon
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Abstract

Background: Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) poses significant diagnostic difficulties due to its similarity in the appearance of skin lesions with chronic inflammatory disorders and other dermatological conditions. This study aims to investigate these challenges by conducting a comprehensive analysis of a case presenting with PC-ALCL, emphasizing the necessity of accurate differentiation for appropriate management.

Case summary: An 89-year-old female patient with diabetes and hypertension presented with arm and abdominal ulcerated mass lesions. Diagnostic procedures included skin biopsies, histopathological assessments, and immunohistochemistry, complemented by advanced imaging techniques to confirm the diagnosis. The patient's lesions were determined as PC-ALCL, characterized by necrosis, chronic inflammation, and a distinct immunophenotypic profile, including CD30, CD3, CD4, and EBER, CD56, MUM-1, Ki 67-positive in > 80% of tumor cells, CD10, but negative for anaplastic lymphoma kinase, CD5, CD20, PAX-5, Bcl-2, Bcl-6, CD8, and CD15. Recurrence was not reported at the 6-month follow-up.

Conclusion: Accurate PC-ALCL differentiation from similar conditions is crucial for effective management and requires a multidisciplinary approach.

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伴有坏死、炎症和手术干预的原发性皮肤无细胞大细胞淋巴瘤的诊断和管理难题:病例报告。
背景:原发性皮肤无细胞大细胞淋巴瘤(PC-ALCL)由于其皮损外观与慢性炎症性疾病和其他皮肤病相似,给诊断带来了很大困难。本研究旨在通过对一例 PC-ALCL 病例进行综合分析来探讨这些难题,强调准确鉴别以进行适当治疗的必要性。病例摘要:一名 89 岁的女性患者患有糖尿病和高血压,出现手臂和腹部溃疡性肿块病变。诊断程序包括皮肤活检、组织病理学评估和免疫组化,并辅以先进的成像技术来确诊。患者的病变被确定为 PC-ALCL,其特点是坏死、慢性炎症和独特的免疫表型特征,包括 CD30、CD3、CD4 和 EBER、CD56、MUM-1、大于 80% 的肿瘤细胞 Ki 67 阳性、CD10,但无性淋巴瘤激酶、CD5、CD20、PAX-5、Bcl-2、Bcl-6、CD8 和 CD15 阴性。6个月的随访未发现复发:结论:准确区分 PC-ALCL 与类似病症对于有效治疗至关重要,需要采用多学科方法。
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World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
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期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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