A Case of an Unusually Aggressive Cutaneous Anaplastic Large T-Cell Lymphoma in an HIV Patient Treated with CHOP

Abstract

Anaplastic large cell lymphoma (ALCL) is the second most common malignancy of T-cell phenotype. This case report describes an unusual rapidly progressing cutaneous anaplastic large T-cell lymphoma in an HIV patient. Our patient is a twenty-year-old African American male with perinatally acquired HIV who presented with a 2 × 2 centimeter necrotic lesion in the right 1st toe; however, 2-3 weeks later multiple smaller lesions appeared on the anterior aspect of the right foot, ankle, and thigh. Biopsy showed cells strongly positive for CD3 and CD30 and negative for CD56 and the ALK gene product. CT of the chest, abdomen, and pelvis was negative for extracutaneous involvement favoring cutaneous ALCL. Patient was treated with 6 cycles of CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) chemotherapy and went into complete remission. Due to the aggressive course that this malignancy follows in HIV patients we suggest prompt treatment with systemic therapy.

Brentuximab vedotin in multifocal cutaneous anaplastic large cell lymphoma in a patient with human immunodeficiency virus following Hodgkin lymphoma

“…Primary cutaneous ALCL occurs in patients aged between 50 and 70 years, presenting as solitary, grouped or multifocal nodules, usually on the upper half of the body, with regional lymph node involvement in around 10% of cases . The literature shows a increased rate of ALCL in HIV‐positive patients, although in most reports the HIV is more advanced with a lower CD4 count than in our patient, and the lymphoma behaves more aggressively. We have also not found any reports of cases of ALCL occurring in connection with HL.…”