Anaplastic Large B-Cell Lymphoma: Cutaneous Presentations

Abstract

Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma characterized by CD30 expression. This report describes the case of a 10-year-old female who presented with non-resolving cutaneous lesions initially treated as a bacterial infection. A biopsy confirmed the diagnosis of anaplastic lymphoma kinase-negative (ALK-negative) ALCL with cutaneous and nodal involvement. Further imaging revealed neoplastic uptake in the right lung, and the patient was diagnosed with Murphy stage II ALCL. She began chemotherapy according to established pediatric oncology protocols. ALCL presents diagnostic challenges due to its non-specific symptoms, which can mimic benign conditions. This case underscores the importance of early biopsy and molecular testing when standard treatments fail. Early recognition and routine examinations, including lymph node assessments and skin biopsies, are critical for improving patient outcomes, as timely diagnosis leads to more effective treatment options and potential remission.

Keywords: alk-negative alcl; anaplastic large cell lymphoma; brentuximab therapy; cd30-positive lymphoma; chemotherapy treatment; cutaneous involvement; lymph node biopsy; pediatric lymphoma; primary cutaneous alcl; t-cell neoplasm.

Figure 1. Initial presentation of pink to violet plaques on the right shoulder with similar plaques located throughout the arms, back, and chest area.

Figure 2. Pink-to-violet plaques on the right antecubital fossa. The red arrow represents the initial punch biopsy site that returned as atypical CD30-positive T-cell lymphoid infiltrate.

Figure 3. PET CT full-body scan demonstrating right axillary adenopathy and neoplastic uptake in the right lung.