A Case of Primary Cutaneous CD30+/ALK- Anaplastic Large Cell Lymphoma / 대한피부과학회지

Primary cutaneous CD30(Ki-1) positive anaplastic large cell lymphoma(ALCL) is a rare subset of cutaneous lymphoma, with a much better prognosis. ALCL is a heterogeneous process that may have a T-cell, B-cell, or indeterminant(null) phenotype and which may or may not express the anaplastic lymphoma kinase(ALK) oncoprotein. We report a case of ALCL in a 72 year old man. About 4 months ago, multiple erythematous firm ulcerative mass and satellite nodules developed on the right lower leg. The skin lesions rapidly increased in number and size. Some lesions became painful and centrally ulcered. The histologic findings showed a diffuse infiltrate of large lymphocytes with large nuclei, prominent and multiple nucleoli, and ample cytoplasm. Immunohistochemical stainings for CD30, CD5 were positive but stainings for LCA, CD3, CD45RO, CD20, cytokeratin, EMA, and ALK were negative. Therefore, we diagnosed our case as CD 30+/ALK- ALCL.

A Case of Primary Cutaneous CD30(Ki-1)-positive Large Cell Lymphoma Showing Repetitive Spontaneous Regression and Recurrences

Primary cutaneous CD30+ large cell lymphoma(LCL) is a rare cutaneous peripheral T cell lymphoma with a favorable prognosis. This lymphoma characteristically presents itself as a solitary or localized skin tumor with frequent cutaneous relapses and partial or complete spontaneous remission. Recently we saw a sixty-three year old male who had developed primary cutaneous CD30+ large cell lymphoma that waxed and waned. He presented with localized multiple nodules that had shown repetitive spontaneous regression and recurrences with the same morphology in the same area for several years. There was no evidence of nodal and visceral involvement. The immunohistochemical studies demonstrated that most neoplastic cells in the tumor were positive for CD30 and pan-T cells and negative for pan-B cells, S-100 proteins, EMA and monocyte-macrophage related antigen(CD68).

A Case of CD3O-negative Large T-Cell Lymphoma Showing p53 and mdm-2 Expression / 대한피부과학회지

Primary cutaneous large cell lymphomas of the T-cell phenotype are relatively uncommon. Previous studies have revealed the following prognostic variables: the distribution of skin lesions, a history of pre-existing mycosis fungoides, CD30(Ki-1) antigen positivity and anaplastic morphology. CD30 antigen positivity has been associated with an indolent clinical course, in contrast to CD30-negative cases. However, a recent study revealed that multicentric skin lesions confer a worse prognosis on this subgroup of patients rather than the absence of CD30 antigen. p53 immunoreactivity also has been reported to be associated with high grade non-Hodgkin's lymphoma, although it is relatively uncommon. Herein, we report a case of a patient with EBV-related, CD30-negative primary cutaneous large cell lymphoma of the T-cell phenotype showing p53 and mdm-2 expression. She was initially diagnosed as having a benign-looking deep folliculitis or furunculosis, but treated successfully with radiation therapy without recurrence up to now.

Primary Cutaneous CD30(Ki-1)-Positive Pleomorphic Large Cell Lymphoma in a Patient with Generalized Lichen Myxedematosus

A case of primary cutaneous CD30(Ki-1)-positive pleomorphic large cell lymphoma in a 51-year-old woman with generalized lichen myxedematosus is presented. Histopathological findings of the biopsy specimens from the lichenoid papules of the left forearm and the dorsum of the right hand were compatible with papular mucinosis. The mucinous material in the papillary dermis stained with alcian blue at pH 2.5 and was susceptible to hyaturonidase, but serum protein electrophoresis showed no abnormal bands and an abnormal paraprotein was not detected in our patient. Histopathological examination of a solitary, firm, purplish nodule on the right popliteal area showed diffuse and extensive infiltration in the reticular dermis composed of large, atypical, often hyperchromatic, sometimes multinucleated and markedly pleomorphic cells. The majority of the large atypical cells were CD30(Ki-1) positive. The TCR gene re-arrangement analysis demonstrated the presence of a monoclonal rearrangement of the y-TCR gene in the skin biopsy specimen of our patient. The organ-system survey revealed no evidence of internal organ involvement. We concluded that this was primary cutaneous CD30(Ki-1)-positive pleomorphic large cell lymphoma developing in a patient with generalized lichen myxedematosus.

Lymphomatoid Papulosis Presenting a Single Nodule

Lymphomatoid papulosis is a chronic disease of cutaneous atypical lymphoid infiltration characterized clinically by involuting and recurring papules, plaques, and sometimes nodules. A 51-year-old man presented with a single, coin sized, nontender, erythematous nodule on the left thigh of a 2-week duration. There was a history of recurrence and spontaneous healing of similar asymptomatic eruptions five to six times over 20 years. A biopsy specimen showed a dense, wedge-shaped dermal infiltrate that was patchy and perivascular. The cellular infiltrate was polymorphous and consisted of large atypical cells, small lymphocytes, eosinophils and neutrophils. The large atypical cells were strongly CD30(Ki-1) positive. We report a case of lymphomatoid papulosis unusually presenting as a single nodular eruption, in which the differential diagnosis between lymphomatoid papulosis and CD30(Ki-1)positive large cell lymphoma is exceedingly difficult.

Two Cases of Lvmphomatoid Papulosis / 대한피부과학회지

Lymphomatoid papulosis(LyP) is a chronic recurrent dermatosi characterized by involuting and recurring papules, plaques, and nodules showing histologic feaurs suggesting rnalignant lymphoma. On histologic ground, it is divided into two types. type A and type B. In type A, large atypical lymphocytes are the main cellular cornponent and most of these express CD 30(Ki-1) antigen, which has been p!reviously thought to be specific for Read Sternberg cells of Hodgkins disease. In type B, cerebriform mononuclear lymphocytes sirr la to those in mycosis fungoides predominates. We report two cases of lymphomatoid papulosis, type A and type B, respectively. The large atypical cells in type A LyP expressed Ki 1 antigen. Both case were treated with PUVA and the outcome of the treatment has been fair.