Pyogenic variant of primary cutaneous CD30+ anaplastic large‐cell lymphoma: Spontaneous remission in a young adult

Hees, Henrik; Geissler, Eva; Wolter, M.; Lamos, Cristina; Löser, Christoph; Dippel, Edgar

doi:10.1111/ddg.13315

Cited by 3 publications

(6 citation statements)

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“…1,2 A rich inflammatory background of neutrophils and eosinophils can be seen in some cases, giving rise to the so-called "pyogenic" variant, where the neoplastic infiltrate can be obscured by inflammatory cells. [4][5][6][7] In 1990, Chan et al 8 reported a case of ALCL with surrounding myxoid stroma, similar to that seen in malignant mesenchymal tumors. A subsequent lymph node biopsy showed a tumor composed of markedly atypical spindle cells reminiscent of the storiform pattern of an undifferentiated pleomorphic sarcoma.…”

mentioning

confidence: 86%

Spindle-cell (Sarcomatoid) Variant of Cutaneous Anaplastic Large-cell Lymphoma (C-ALCL)

Gru

Bhagat

Subtil

et al. 2020

American Journal of Surgical Pathology

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Cutaneous anaplastic large-cell lymphoma (C-ALCL) represents one of the entities within the group of CD30-positive lymphoproliferative disorders of the skin. Most cases are ALK-negative, though isolated cases of ALK-positive C-ALCL have also been reported. By definition, the diagnosis of C-ALCL requires the expression of CD30 in >75% of the cells. Histopathologically, C-ALCL shows a dermal-based nodular and circumscribed proliferation of large pleomorphic cells with vesicular nuclei, prominent nucleoli, and eosinophilic cytoplasm, including hallmark cells. Since 1990, isolated case reports of a so-called “sarcomatoid” variant have been published in the literature. Herein, we present a series of 11 cases of spindle (sarcomatoid) C-ALCL, with comprehensive histopathologic, immunophenotypic, and molecular data. Spindle C-ALCL represents a potential mimicker of malignant mesenchymal or hematopoietic tumors in the skin and should always be considered in the differential diagnosis when assessing cutaneous pleomorphic spindle cell neoplasms.

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mentioning

confidence: 86%

Spindle-cell (Sarcomatoid) Variant of Cutaneous Anaplastic Large-cell Lymphoma (C-ALCL)

Gru

Bhagat

Subtil

et al. 2020

American Journal of Surgical Pathology

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“…[3][4][5] Multiagent chemotherapy is considered in case of regional lymph node involvement. 2 Recently, some authoritative articles have been published regarding the utilization of radiation therapy (RT) in the treatment of PCALCL in order to determine the optimal dose 6,7 and to collect data potentially useful to predict the outcome after such treatment. 8 To give a contribution to this debate, we report our experience with conventional energy RT and consider the literature data about this topic.…”

Section: % Of the Cutaneous T-cell Lymphomas According To The 2005mentioning

confidence: 99%

“…More than 75% of tumor cells express CD30 antigen. The clinical picture is identified by the onset of solitary or localized nodules or tumors, often ulcerated and sometimes simulating aggressive pyoderma or skin cancer . A partial or complete spontaneous regression is possible, but relapses in the skin are frequent, while extracutaneous dissemination is observed in 10% of cases, involving regional lymph nodes in most cases.…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy of primary cutaneous anaplastic large cell lymphoma: our experience in 30 cases

et al. 2020

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Background Since the observation of new cases of primary cutaneous anaplastic large cell lymphoma (PCALCL) with a seemingly aggressive clinical presentation and a favorable response to radiation therapy (RT), a review of our series has been performed to evaluate the results of RT. Materials and methods The study is a retrospective analysis of 30 patients with PCALCL treated with conventional energy RT. Results About 55 fields of irradiation were performed. Complete clinical response (CCR) was obtained in 29 cases and a partial clinical response (PCR) in one. Two lesions had a marginal relapse at 7 and 37 months, respectively. In eight cases, new lesions appeared in the same body district and in six cases, in body sites at distance from the field of treatment. Total radiation dose ranged from 15 to 35 Gy (median 25 Gy). Follow‐up range was 2–218 months (median 38.5 months) with a local control rate of 85% and a relapse‐free rate of 49% at 5 years from RT. Three cases developed a nodal involvement. Conclusions PCALCL belongs to the group of primary cutaneous CD30+ lymphoproliferative disorders, accounting for 25–30% of cutaneous T‐cell lymphomas. RT is considered of choice as alternative to surgical excision of solitary lesions. Recent studies have focused on ideal dose to obtain local control indicating 30 Gy as adequate, but others have hypothesized that lower doses may suffice. Our study confirms the excellent role of RT in the local control of the disease with total doses ≤25 Gy.

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“…CD30 + pcALCL generally has a favourable prognosis with a 5-year survival rate of >90% and spontaneous resolution in approximately 25% of patients (9,10), therefore a watchand-wait approach might be reasonable. Nevertheless, in patients with extensive limb disease (multiple lesions on the leg) the 5-year survival rate is much lower, at only 50% (11).…”

Section: Fast-growing Painful Leg Ulcers In a 26-year-old Woman With mentioning

confidence: 99%

Fast-growing Painful Leg Ulcers in a 26-year-old Woman with Systemic Lupus Erythematosus: A Quiz

Hartmann

Haenssle²,

Enk³

et al. 2019

Acta Derm Venerol

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Pyogenic variant of primary cutaneous CD30+ anaplastic large‐cell lymphoma: Spontaneous remission in a young adult

Cited by 3 publications

References 10 publications

Spindle-cell (Sarcomatoid) Variant of Cutaneous Anaplastic Large-cell Lymphoma (C-ALCL)

Spindle-cell (Sarcomatoid) Variant of Cutaneous Anaplastic Large-cell Lymphoma (C-ALCL)

Radiotherapy of primary cutaneous anaplastic large cell lymphoma: our experience in 30 cases

Fast-growing Painful Leg Ulcers in a 26-year-old Woman with Systemic Lupus Erythematosus: A Quiz

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