Primary cutaneous anaplastic large cell lymphoma belongs to the group of cutaneous processes that are CD30+ lymphoproliferative and are characterized by autoregressive, recurrent, single or multifocal ulcerating nodules. Single or localized nodules, papules, or plaques are present in the majority of patients. However, a patient may have more than one lesion in up to 20% of cases.[1]
| Primary cutaneous CD30 positive anaplastic large cell lymphoma | |
|---|---|
| Other names | Primary cutaneous anaplastic large cell lymphoma. |
| Specialty | Dermatology |
For patients with localized lesions, the recommended courses of treatment include radiation therapy, lesion removal, and/or low-dose methotrexate.[2] Systemic polychemotherapy is indicated for the treatment of diseases that progress quickly or that are extracutaneous.[3]
Signs and symptoms
editPrimary cutaneous anaplastic large cell lymphoma typically manifests as multifocal, solitary, or grouped nodules on the upper limbs that last for three to four weeks.[4]
Causes
editThe cause is complex and multifaceted. Only a small proportion of patients have CD30+ cells in normal lymphoid tissue. These are the cells that are thought to be the precursors of systemic anaplastic large cell lymphoma. It is believed that CD30's interaction with its ligand, CD30L, mediates the disease's proliferative and anti-proliferative phases.[4] The chemokine receptors CCR8 and CCR10, which are implicated in skin localization, are also assumed to mediate cutaneous presentation through their expression. Another theory is that Langerhans cell-mediated antigen presentation chronically activates T cells, leading to cutaneous T cell lymphomas.[5]
Diagnosis
editPrimary cutaneous anaplastic large cell lymphoma is characterized histologically by large, irregular polygonal cells distributed in sheets throughout the dermis and occasionally the subcutis.[6]
Treatment
editComplete surgical resection and/or radiation therapy are used to treat primary cutaneous anaplastic large cell lymphoma as a single lesion; the majority of patients experience total remission.[7] While radiation of the primary lesion and the surrounding lymph nodes has been advised for patients whose local lymph nodes are involved, adding radiation to surgical excision does not seem to improve localized disease.[8]
See also
editReferences
edit- ^ Oliveira, Luciana Silveira Rabello de; Nobrega, Madeleyne Palhano; Monteiro, Maira Gomes; Almeida, Wagner Leite de (2013). "Primary cutaneous anaplastic large-cell lymphoma — case report". Anais Brasileiros de Dermatologia. 88 (6 suppl 1). FapUNIFESP (SciELO): 132–135. doi:10.1590/abd1806-4841.20131731. ISSN 0365-0596. PMC 3875977. PMID 24346900.
- ^ Diamantidis, Michael D.; Myrou, Athena D. (2011). "Perils and Pitfalls Regarding Differential Diagnosis and Treatment of Primary Cutaneous Anaplastic Large-Cell Lymphoma". The Scientific World Journal. 11. Hindawi Limited: 1048–1055. doi:10.1100/tsw.2011.80. ISSN 1537-744X. PMC 5720019. PMID 21552770.
- ^ Diamantidis, Michael D.; Papadopoulos, Athanasios; Kaiafa, Georgia; Ntaios, George; Karayannopoulou, Georgia; Kostopoulos, Ioannis; Girtovitis, Fotios; Saouli, Zoi; Kontoninas, Zisis; Raptis, Ioannis D.; Savopoulos, Christos; Hatzitolios, Apostolos (June 23, 2009). "Differential diagnosis and treatment of primary, cutaneous, anaplastic large cell lymphoma: not always an easy task". International Journal of Hematology. 90 (2). Springer Science and Business Media LLC: 226–229. doi:10.1007/s12185-009-0365-7. ISSN 0925-5710. PMID 19548068. S2CID 42622679.
- ^ a b Brown, Ryanne A.; Fernandez-Pol, Sebastian; Kim, Jinah (2017). "Primary cutaneous anaplastic large cell lymphoma". Journal of Cutaneous Pathology. 44 (6): 570–577. doi:10.1111/cup.12937. ISSN 0303-6987. PMID 28342276.
- ^ Moodley, Nerissa; Nombona, Patiswa; Mosam, Anisa (June 26, 2019). "Primary Cutaneous Anaplastic Large-Cell Lymphoma". Dermatopathology. 6 (2). MDPI AG: 163–169. doi:10.1159/000500259. ISSN 2296-3529. PMC 6827451. PMID 31700858.
- ^ Paulli, M; Berti, E; Rosso, R; Boveri, E; Kindl, S; Klersy, C; Lazzarino, M; Borroni, G; Menestrina, F; Santucci, M (1995). "CD30/Ki-1-positive lymphoproliferative disorders of the skin--clinicopathologic correlation and statistical analysis of 86 cases: a multicentric study from the European Organization for Research and Treatment of Cancer Cutaneous Lymphoma Project Group". Journal of Clinical Oncology. 13 (6). American Society of Clinical Oncology (ASCO): 1343–1354. doi:10.1200/jco.1995.13.6.1343. ISSN 0732-183X. PMID 7751878.
- ^ Ortiz-Hidalgo, Carlos; Pina-Oviedo, Sergio (August 14, 2023). "Primary Cutaneous Anaplastic Large Cell Lymphoma—A Review of Clinical, Morphological, Immunohistochemical, and Molecular Features". Cancers. 15 (16). MDPI AG: 4098. doi:10.3390/cancers15164098. ISSN 2072-6694. PMC 10452173. PMID 37627126.
- ^ Liu, Howard L.; Hoppe, Richard T.; Kohler, Sabine; Harvell, Jeff D.; Reddy, Sunil; Kim, Youn H. (2003). "Cd30+ cutaneous lymphoproliferative disorders: The stanford experience in lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma". Journal of the American Academy of Dermatology. 49 (6). Elsevier BV: 1049–1058. doi:10.1016/s0190-9622(03)02484-8. ISSN 0190-9622. PMID 14639383.
Further reading
edit- Kumar, Shimareet; Pittaluga, Stefania; Raffeld, Mark; Guerrera, Michael; Seibel, Nita L.; Jaffe, Elaine S. (2005). "Primary Cutaneous CD30-Positive Anaplastic Large Cell Lymphoma in Childhood: Report of 4 Cases and Review of the Literature". Pediatric and Developmental Pathology. 8 (1). SAGE Publications: 52–60. doi:10.1007/s10024-004-8087-6. ISSN 1093-5266. PMID 15719203. S2CID 25798596.
- Sarfraz, H.; Gentille, C.; Ensor, J.; Wang, L.; Wong, S.; Ketcham, M. S.; Joshi, J.; Pingali, S. R. K. (July 17, 2021). "Primary cutaneous anaplastic large-cell lymphoma: a review of the SEER database from 2005 to 2016". Clinical and Experimental Dermatology. 46 (8). Oxford University Press (OUP): 1420–1426. doi:10.1111/ced.14777. ISSN 0307-6938. PMID 34081802. S2CID 235335222.