Primary cutaneous anaplastic large cell lymphoma with intralymphatic involvement associated with chronic lymphedema.
Chronic lymphedema predisposes to develop malignant cutaneous tumors, including angiosarcoma, Kaposi's sarcoma and B-cell lymphoma. T-cell malignancy has rarely been associated with chronic lymph stasis. Here, we report a case of primary cutaneous anaplastic large cell lymphoma (pcALCL) with lymphatic spread associated with chronic lymphedema. The patient is a 56-year-old man who received orchiectomy and right inguinal lymphadenectomy for malignant seminoma 10 years ago, which led to prominent lymphedema of the right leg. He developed extensive skin nodules on the lymphedematous area for 3 months. Histopathology findings confirmed a diagnosis of pcALCL, which is a subtype of cutaneous T-cell lymphoma characterized by the presence of CD30+ T cells. Intralymphatic infiltration of malignant cells is prominent. The pathogenesis of intralymphatic cutaneous anaplastic large cell lymphoma is largely unknown. Our case suggests that chronic lymphedema resulted in persistent CD4+ T-cell inflammation, which then may contribute to the development of pcALCL.
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Peiyuan
P
Fan
Department of Pathology, Peking University First Hospital, Beijing, China.
Lin
L
Nong
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Jingru
J
Sun
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Xiaoqing
X
Liu
Department of Dermatology and Skin Surgery, Boston University School of Medicine, Providence, Rhode Island.
Marshall E
ME
Kadin
Department of Pathology, Peking University First Hospital, Beijing, China.
Ting
T
Li
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Ping
P
Tu
Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.
Yang
http://orcid.org/0000-0001-7805-2861
Y
Wang
immunosuppression; inflammation; lymphedema; pathogenesis; primary cutaneous anaplastic large cell lymphoma