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Remission of refractory granulomatous primary cutaneous anaplastic large cell lymphoma to brentuximab vedotin
  1. Appalanaidu Sasapu1,
  2. Andrew L J Dunn2,
  3. Jerad Gardner3 and
  4. Henry K Wong4
  1. 1Medicine, Division of Hematology Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  2. 2Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  3. 3Pathology, Geisinger Medical Laboratories, Danville, Pennsylvania, USA
  4. 4Dermatology, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
  1. Correspondence to Dr Henry K Wong; hkwong{at}uams.edu

Abstract

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is a rare non-Hodgkin’s lymphoma that arises as a single, or multiple dome-shaped tumours on the skin. The histology is characterised by the presence of atypical lymphocytes with large irregularly shaped nuclei that express the surface marker CD30. There can be significant heterogeneity in clinical manifestation and histological pattern and in rare cases accurate diagnosis can be a challenge. Here, we present an unusual case presentation of cutaneous CD30+ anaplastic large cell lymphoma with significant granulomatous histology pattern that mimicked sarcoid. After a lack of durable response to treatments that included glucocorticoid and methotrexate, targeted treatment with anti-CD30 monoclonal antibody drug conjugate (brentuximab vedotin) yielded long-term clinical remission.

  • dermatology
  • oncology

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Footnotes

  • Twitter @JMGardnerMD

  • Contributors AS treated the patient and contributed to writing and editing the manuscript. ALJD reviewed the history, medical records, pathology, literature and contributed to the writing the manuscript. JG interpreted the histopathology and edited the manuscript. HKW treated the patient, reviewed the medical records, reviewed the literature and contributed to prepraration, writing and editing the manuscript. All authors approved the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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