Relapsing lymphomatoid papulosis after allogenic bone-marrow transplant.
Lymphomatoid papulosis (LyP) is a rare cutaneous lymphoproliferative disorder in children, which can rarely be associated with a cutaneous or systemic lymphoma. We report a 13-year-old girl who presented with typical LyP and pathological features of subtype A. Six months later, the patient presented with rapidly progressive peripheral and systemic lymphadenopathy. On examination of a lymph-node biopsy, a lymphoid infiltrate negative for anaplastic lymphoma kinase (ALK) and positive for CD30 was found, suggestive of systemic anaplastic large T-cell lymphoma (S-ALCL). The patient was treated with chemotherapy, followed by allogeneic bone-marrow transplant (BMT). Over the following 6 years, she presented with biopsy-confirmed LyP relapses with complete cutaneous, peripheral-blood and bone-marrow chimerism. This is only the third reported paediatric association of S-ALCL with LyP to our knowledge, and seems to be the first paediatric case of recurrent relapses of LyP after bone-marrow allograft for S-ALCL with total (100%) cutaneous and bone-marrow chimerism. LyP occurring after allogenic BMT does not appear to be donor-derived.
Department of Dermatology, CHU Hôtel Dieu, Nantes, France.
J
J
Miquel
M
M
Vourc'h-Jourdain
C
C
Thomas
E
E
Cassagnau
J-F
JF
Stalder
S
S
Barbarot
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000601:surgery*; D017731:Lymphomatoid Papulosis / Q000209:etiology*; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000209:etiology*