A Rare and Isolated Presentation of Primary Cutaneous Anaplastic Large Cell Lymphoma on the Breast

Abstract

Primary cutaneous anaplastic large-cell lymphoma (PC-ALCL) is a subtype of non-Hodgkin lymphoma belonging to the CD30+ spectrum of lymphoproliferative disorders. It constitutes the second most prevalent category within cutaneous T-cell lymphomas (CTCL), encompassing approximately 25% of cases. This disorder is characterized by its exclusive cutaneous involvement and favorable overall prognosis. Patients typically present with reddish-brown nodules, which may evolve into ulcers. Although some cases experience regression, complete resolution is uncommon. While most lesions manifest on the extremities, followed by the head and neck, the breast region may rarely be affected by PC-ALCL. Distinctions between anaplastic lymphoma kinase (ALK)-positive and ALK-negative subtypes have been documented in breast presentations, often associated with breast implants. In this context, we present an isolated PC-ALCL instance in a 26-year-old woman with no history of breast implants.

Keywords: anaplastic lymphoma; breast; ctcl: cutaneous t-cell lymphoma; cutaneous lymphoma; lymphomatoid papulosis; primary cutaneous anaplastic large cell lymphoma; primary cutaneous t-cell lymphoma; t cell; t-cell cutaneous; t-cell lymphomas.

Figure 1. Solitary red ulcerated nodule located on the right breast (a); prior to surgical excision (b)

Figure 2. Histologic sections showing extensive infiltration by large, pleomorphic anaplastic lymphoid cells (a); immunohistochemical studies reveal that neoplastic cells are positive for EMA (b), CD30 (c), and CD43 (d).