Site Under Construction

Primary cutaneous anaplastic large cell lymphoma in a 73-year-old Filipino male

Juan Antonio D. Cervantes, MD, Eunice Kaye M. Rayos-Lopez, MD, DPDS, Ma. Teresita G. Gabriel, MD, FPDS, Reynaldo L. Ugalde, MD, FPDS, Johannes F. Dayrit, MD, FPDS, FDSP



Primary cutaneous anaplastic large cell lymphoma (PCALCL) is an uncommonly encountered subtype of cutaneous lymphoma under the classification of CD30-positive lymphoproliferative disorders which presents histologically as large atypical lymphocytes with pleomorphic and anaplastic cytology that localizes to the dermis. Although recurrent, PCALCL usually carries a good prognosis, with 5-year survival rates ranging from 85% to 95%.



We report a 73-year-old elderly male who consulted at our out-patient department with a 3-year and 6-month history of multifocal, gradually enlarging, erythematous nodules with dry, necrotic areas on the scalp, right auricular area, left axillary area, right forearm, and right thigh, accompanied by loss of appetite and nontender cervical, left axillary, and right inguinal lymphadenopathy. Previous skin punch biopsy and immunohistochemical stain done by the patient’s preceding dermatologist was signed out as “suggestive” of pseudolymphoma. However, management with intralesional corticosteroid injections provided no improvement. Skin punch biopsy done at our institution revealed ALK negative (-) anaplastic large cell lymphoma. Patient was then referred to an oncologist, however, the patient was lost to follow-up and succumbed to community acquired pneumonia.



This case highlights the importance of a thorough diagnostic assessment as recent studies indicate a poorer prognosis of ALK (-) cases, with overall 5-year survival rates consistently below 50%.


  1. Willemze R, Jaffe ES, Burg G, Cerroni L, Berti E, Swerdlow SH, et al. WHO- EORTC classification for cutaneous lymphomas. Blood. 2005;105:3768-85.
  2. Webb, T. R., Slavish, J., George, R. E., Look, A. T., et al. Anaplastic lymphoma kinase: role in cancer pathogenesis and small-molecule inhibitor development for therapy. Expert Rev Anticancer Ther. 2009;9(3)331–356.
  3. Hapgood G, Pickles T, et al. Outcome of primary cutaneous anaplastic large cell lymphoma: a 20-year British Columbia Cancer Agency experience. Br J Haematol. 2016;176.10.1111/bjh.14404
  4. Rubio-Gonzales B, Zain J, Rosen ST, Querfeld C. Clinical manifestations and pathogenesis of cutaneous lymphomas: current status and future directions. Br J Haematol. 2017;176,16-36.
  5. Ferreri A, Govi S, Pileri S, Savage K. Anaplastic large cell lymphoma, ALK- negative. Crit Rev Oncol Hematol. 2013;206-215
  6. Uzuncakmak TK, Akdeniz N, Karadag AS, Taskin S, Zemheri EI, Argenziano G. Primary cutaneous CD 30 (+) ALK (-) anaplastic large cell lymphoma with dermoscopic findings: a case report. Dermatol Pract Concept. 2017;7(1):12

REquesting Permission

Primary cutaneous anaplastic large cell lymphoma in a 73-year-old Filipino male