A rare localised nasal CD30⁺primary cutaneous T-cell lymphoma following liver transplantation

Abstract

SUMMARY Cutaneous T-cell post-transplant lymphoproliferative disorder (PTLD) is a rare clinical presentation that can potentially turn aggressive in solid-organ transplant recipients if not detected and intervened on early. We encountered a rare case of rapidly worsening primary cutaneous CD30-positive, Epstein-Barr virus-negative anaplastic large cell lymphoma (ALCL) of T-cell origin, manifesting as an isolated nasal tip lesion in a 71-year-old man 4 years after orthotopic liver transplantation. Excisional biopsy with partial rhinectomy showed subepithelial diffuse infiltration of medium-to-large lymphoid cells having round-to-irregular nuclei, partially condensed chromatin and prominent nucleoli. Immunophenotypic studies revealed CD30-positive primary cutaneous ALCL. Positron emission tomography/CT imaging revealed a locally active disease, and radiation therapy was initiated with complete response. A high index of suspicion for PTLD when evaluating skin lesions in a post-transplant patient is paramount for its early recognition, prompt diagnosis and timely intervention while the window for curative therapy remains possible.

Primary Cutaneous Natural Killer/T-Cell Lymphoma

“…The present case had a history of bone marrow transplantation, which rarely results in cutaneous PTLD. B-cell origin is the most common PTLD subtype 2,3 . However, primary cutaneous PTLD tends to be of T-cell origin 4 .…”

“…B-cell origin is the most common PTLD subtype. 2,3 However, primary cutaneous PTLD tends to be of T-cell origin. 4 Posttransplant lymphoproliferative disorder of NK/T-cell origin is a very rare and serious disease that can involve both solid organ and bone marrow transplant patients.…”