Pediatric case of anaplastic lymphoma kinase‐positive anaplastic large cell lymphoma forming a solitary skin tumor on the forearm

• Published in: Journal of dermatology Vol. 44; no. 4; pp. 465 - 467
• Main Authors: Tokuyama, Michio, Kurashige, Yuta, Ota, Tami, Manabe, Yasuaki, Yamaoka, Hanako, Ikoma, Norihiro, Fukumura, Akiko, Miyashita, Michie, Otsubo, Keisuke, Morimoto, Tsuyoshi, Mochizuki, Hiroyuki, Nakano, Natsuko, Nakamura, Naoya, Ozawa, Akira, Mabuchi, Tomotaka
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2017
• Subjects: Anaplastic large-cell lymphoma; anaplastic lymphoma kinase; Antibiotics; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biopsy; Bone marrow; CD30 antigen; CD4 antigen; Cell Nucleus; Chemotherapy; Child, Preschool; children; Computed tomography; Cytoplasm; Female; Forearm; Humans; Immunohistochemistry; Lymph; Lymph nodes; Lymphadenopathy; Lymphoma; Lymphoma, Large-Cell, Anaplastic - diagnosis; Lymphoma, Large-Cell, Anaplastic - metabolism; Lymphoma, Large-Cell, Anaplastic - pathology; Lymphoma, Large-Cell, Anaplastic - therapy; Metastases; Oral cavity; Pediatrics; Protein-tyrosine kinase; Receptor Protein-Tyrosine Kinases - metabolism; Skin; Skin - pathology; Skin cancer; Skin Neoplasms - diagnosis; Skin Neoplasms - drug therapy; Skin Neoplasms - metabolism; Skin Neoplasms - pathology; skin; anaplastic large cell lymphoma; children; chemotherapy; anaplastic lymphoma kinase
• ISSN: 0385-2407; 1346-8138
• DOI: 10.1111/1346-8138.13688

A 5‐year‐old girl noticed a rapidly growing reddish nodule on her right forearm. Although oral antibiotics had been administrated for 2 weeks, the tumor enlarged. Skin biopsy revealed excessive infiltration of atypical neoplastic cells expressing CD4, CD30 and anaplastic lymphoma kinase (ALK). These histological and immunohistochemical findings were consistent with anaplastic large cell lymphoma (ALCL). Computed tomography showed multiple lymphadenopathy, but lymph node biopsy and bone marrow examination did not show any evidence of systemic dissemination. However, due to the positive results for ALK and multiple lymphadenopathy, we diagnosed ALK‐positive ALCL forming a solitary skin tumor on the forearm. The patient received chemotherapy and presented marked improvement. This paper discusses the difficulty of diagnosing pediatric ALK‐positive ALCL limited to the skin and reviews the medical published work.