Systemic anaplastic large cell lymphoma presenting with cutaneous manifestations in a young man: a case report.
Skin lesions can be a sign of internal disease. When they are associated with persisting systemic signs, the possibility of an internal malignancy should always be considered. We describe a 25-year-old man who presented with weight loss, fatigue, subpyrexia, xerostomia and skin rash of 6 months duration. Physical examination showed a dry red skin, most prominent in the face, the palms of the hands and the soles of the feet. Laboratory investigations revealed signs of inflammation and a high level of antinuclear antibodies. Retroperitoneal lymph nodes were visualized on a CT scan of the abdomen. CT-guided biopsy of an abdominal lymph node revealed the presence of an anaplastic large cell lymphoma (ALCL), ALK-positive. A biopsy of the skin showed non-specific signs of inflammation.The patient underwent 8 cycles of chemotherapy according to the CHOP protocol. A complete remission was obtained. Non-Hodgkin lymphoma can indeed be associated with skin lesions. They result from direct invasion by malignant cells or are of paraneoplastic origin, as was the case in this patient.
Department Interne Geneeskunde, Universitair Ziekenhuis Brussel, Brussel, België. Nathalie.Vandewalle@uzbrussel.be
N
N
Vande  Walle
E
E
Van den Enden
K
K
Fostier
A
A
De Coninck
K
K
Nieboer
B
B
Velkeniers
P
P
Lacor
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D012871:Skin Diseases / Q000209:etiology; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone