Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2024; 12(31): 6486-6492
Published online Nov 6, 2024. doi: 10.12998/wjcc.v12.i31.6486
Diagnostic and management challenges in primary cutaneous anaplastic large cell lymphoma with necrosis, inflammation, and surgical intervention: A case report
Jun Mo Kim, Woo Young Choi, Ji Seon Cheon
Jun Mo Kim, Woo Young Choi, Ji Seon Cheon, Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, Gwangju 61453, South Korea
Author contributions: Kim JM, Choi WY and Cheon JS designed the case study; Kim JM analyzed the data; Choi WY wrote the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Woo Young Choi, PhD, Professor, Surgeon, Department of Plastic Reconstructive Surgery, Chosun University College of Medicine, 365, Pilmun-daero, Dong-gu, Gwangju 61453, South Korea. woo3847@gmail.com
Received: May 8, 2024
Revised: August 19, 2024
Accepted: August 28, 2024
Published online: November 6, 2024
Processing time: 125 Days and 19.6 Hours
Abstract
BACKGROUND

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) poses significant diagnostic difficulties due to its similarity in the appearance of skin lesions with chronic inflammatory disorders and other dermatological conditions. This study aims to investigate these challenges by conducting a comprehensive analysis of a case presenting with PC-ALCL, emphasizing the necessity of accurate differentiation for appropriate management.

CASE SUMMARY

An 89-year-old female patient with diabetes and hypertension presented with arm and abdominal ulcerated mass lesions. Diagnostic procedures included skin biopsies, histopathological assessments, and immunohistochemistry, complemented by advanced imaging techniques to confirm the diagnosis. The patient’s lesions were determined as PC-ALCL, characterized by necrosis, chronic inflammation, and a distinct immunophenotypic profile, including CD30, CD3, CD4, and EBER, CD56, MUM-1, Ki 67-positive in > 80% of tumor cells, CD10, but negative for anaplastic lymphoma kinase, CD5, CD20, PAX-5, Bcl-2, Bcl-6, CD8, and CD15. Recurrence was not reported at the 6-month follow-up.

CONCLUSION

Accurate PC-ALCL differentiation from similar conditions is crucial for effective management and requires a multidisciplinary approach.

Keywords: Primary cutaneous anaplastic large cell lymphoma; Chronic inflammation; Necrosis; Diagnostic challenges; Dermatological oncology; Case report

Core Tip: This case report describes the diagnostic complexities and management strategies for primary cutaneous anaplastic large cell lymphoma (PC-ALCL), emphasizing the difficulties posed by its necrosis and chronic inflammation presentation. This report underscores the necessity of distinguishing PC-ALCL from similar chronic inflammatory conditions by detailing a patient’s journey from initial misdiagnosis to the tailored multidisciplinary approach that follows. This case illustrates the critical role of precise diagnostic techniques in guiding effective treatment plans for dermatological malignancies through histopathological examinations and immunophenotyping.