Abstract
Among non-Hodgkin's lymphomas (NHLs), anaplastic lymphoma kinase (ALK)-positive anaplastic
large cell lymphoma (ALCL) is a relatively uncommon subtype that accounts for 3% of
all adult NHLs. It typically affects young males, with a prevalence of three to one.
Most cases present with nodal disease at the time of presentation. An extranodal involvement
is seen in 60% of cases and skin involvement is seen in only 8 to 21% of cases. Cutaneous
involvement in ALCL can manifest as primary cutaneous ALCL or secondary to systemic
ALCL, and while CD30 positivity is common to both, ALK is not expressed by the former.
A secondary skin involvement is usually associated with a poorer prognosis.
We report a rare case of an isolated cutaneous relapse of systemic ALK-positive ALCL
in a 62-year-old woman following the second cycle of chemotherapy. The acute febrile,
widespread papulonodular eruption clinically resembled mycosis fungoides and lymphomatoid
papulosis. With the introduction of oral crizotinib, a drastic improvement in the
skin lesions and an exceptional response on positron emission tomography-computed
tomography were noted.
Keywords
ALCL - ALK-positive anaplastic large cell lymphoma - ALK-positive ALCL - cutaneous
metastasis - crizotinib
