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ALK ‐positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature
Author(s) -
Geller Shamir,
Canavan Theresa N.,
Pulitzer Melissa,
Moskowitz Alison J.,
Myskowski Patricia L.
Publication year - 2018
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13804
Subject(s) - medicine , anaplastic lymphoma kinase , anaplastic large cell lymphoma , lymphoma , systemic disease , disease , radiation therapy , large cell , oncology , pathology , dermatology , cancer , adenocarcinoma , pleural effusion , malignant pleural effusion
Anaplastic large cell lymphoma ( ALCL ) limited to the skin is a distinct disease that is designated primary cutaneous ALCL (pc ALCL ). It has an indolent course with a significantly better prognosis compared to systemic ALCL ( sALCL ). Anaplastic lymphoma kinase ( ALK ) expression in lesions of cutaneous ALCL is classically considered to be a marker for skin involvement by sALCL . However, recent reports of patients with ALK ‐positive pc ALCL challenge this concept and raise prognostic and therapeutic dilemmas. Herein, we report a case of ALK ‐positive pc ALCL in a 45‐year‐old woman who was treated with local radiotherapy. We review previously reported cases in the literature to better characterize this rare variant. Overall, the rates of cutaneous recurrence, systemic dissemination, and disease‐related mortality in ALK ‐positive pc ALCL do not differ from those previously reported in pc ALCL . ALK ‐positive pc ALCL is diagnosed at younger age and has a better disease course in children compared to adults with lower incidences of skin recurrence and progression to systemic disease. We conclude that ALK ‐positivity in cutaneous ALCL does not necessarily imply systemic disease. ALK ‐positive pc ALCL has an excellent prognosis and should be treated by excision and/or radiotherapy. However, patients must remain under close long‐term follow‐up as recurrence and progression to systemic disease may occur.