HIV-associated primary cutaneous anaplastic large cell lymphoma: a clinicopathological subset with more aggressive behavior? Case report and review of the literature.
Human immunodeficiency virus (HIV)-infected patients carry an increased risk of lymphomagenesis. Although the majority of HIV-related lymphomas have a B-cell phenotype, the incidence of peripheral T-cell lymphomas (PTCL), including primary cutaneous subtypes, may be up to 15-fold higher than in the general population, with anaplastic large cell lymphomas (ALCL) accounting for 18-28% of HIV-associated PTCL. In contrast to systemic ALCL, the relation between HIV infection and primary cutaneous ALCL has been relatively neglected in the literature. We report the case of a primary cutaneous ALCL occurring in a 76-year-old patient with advanced HIV infection, and showing unusually aggressive course. Neither ALK1 immunohistochemical positivity nor evidence of EBV infection were detected; staging procedures at initial presentation ruled out systemic involvement. We provide a summary of the literature regarding primary cutaneous ALCL in HIV-infected patients. We draw attention to clinicopathological features, prognostic implications and therapeutic quandaries of HIV-related primary cutaneous ALCL. Further, we propose that a significant fraction of HIV-associated cases might represent a more aggressive subset of primary cutaneous ALCL.
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy. andreasaggini@gmail.com
Andrea
A
Saggini
Lucia
L
Anemona
Sergio
S
Chimenti
Loredana
L
Sarmati
Claudia
C
Torti
Alessandro
A
Di Stefani
Luca
L
Bianchi
D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications* / Q000378:metabolism; D018451:Homosexuality, Male; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D017728:Lymphoma, Large-Cell, Anaplastic / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D008297:Male; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000821:virology
D015703:Antigens, CD; D014408:Biomarkers, Tumor