A Case Of Cutaneous CD+ Anaplastic Large Cell Lymphoma

A 49-years-old woman presented with dark red plaques and nodules with ache on limbs for 3 month. Physical examination:T:36.3℃, R:20bpm, P:80bpm, BP: 110/70mmHg, superficial lymph nodes could not be palpated. Multiple dark red plaques and nodules were distributed over the limbs with a few crust could been seen on the rashes, sized from mung beans to large quail eggs, light tenderness,could not be moved. Biopsy from the left lateral knee showed an aulcer of 1*2cm in diametre. laboratory examination after admission:(32-MG 3.8mg/L, LD 236U/L, three conventional, biological and chemical full, tumor markers, anti-tuberculosis antibody, ANA, T cell subsets, chest radiograph, electrocardiogram showed no obvious abnormalities. HIV-Ab (-), EB virus IgM (-), allergen screening (-), cytomegalovirus IgM (-), respiratory virus Ab (-). B ultrasound:spleen is large, the left cervical nodes, left supraclavicular nodes, right axillary, right inguinal lymph node were enlarged. Skin biopsy(HE) were in agreement with cutaneous anaplastic large cell lymphoma. Immunohistochemistry were also supportive:CD30+++, CD8+++, ALK-, TIA+++, Graryne+++, EMA-, CD56+, CD5+++, Ki67+, CD4-, CD79-, CD20-, CD68-, CD45RO++。T cell receptor rearrangements positive. This article will discuss the case in respect of its differential diagnosis and treatment.