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Pediatric Case of Primary Cutaneous Eosinophil-Rich CD30+ Anaplastic Large-Cell Lymphoma With Follicular Mucinosis

Kacerovska, Denisa MD, PhD*,†; Michal, Michal MD*,†; Kazakov, Dmitry V. MD, PhD*,†

American Journal of Dermatopathology: March 2014 - Volume 36 - Issue 3 - p e78–e80
doi: 10.1097/DAD.0b013e3182914c89
Extraordinary Case Report

Abstract: We report a pediatric case of primary cutaneous CD30+ anaplastic large-cell lymphoma showing a combination of rare histopathologic features. The patient was a 14-year-old boy who had a solitary 2 × 1-cm ulcerated nodule with purulent discharge and undermined borders located in the right preauricular area that had been present for 3 weeks. Histopathologically, there was a dense, nonepidermotropic multinodular to diffuse infiltrate involving the reticular dermis and, focally, the subcutis. The infiltrate was composed of numerous eosinophils, neutrophils, small well-differentiated lymphocytes, and large pleomorphic and anaplastic cells. Eosinophils dominated the infiltrate. Focally, the infiltrate was accentuated around hair follicles, many of which manifested features of follicular mucinosis and/or collections of neutrophils in the follicular epithelium. Occasional hair follicles were partly destroyed by the infiltrate. A conspicuous feature was a prominent myxoid change in the stroma surrounding the hair follicles and eccrine glands. Immunohistochemically, the large lymphoid cells expressed CD2, CD3, CD4, and CD30.

*Sikl's Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; and

Bioptical Laboratory, Pilsen, Czech Republic.

Reprints: Dmitry V. Kazakov, MD, PhD, Sikl's Department of Pathology, Charles University, Medical Faculty Hospital, Alej Svobody 80, 304 60 Pilsen, Czech Republic (e-mail: kazakov@medima.cz).

The authors declare no conflicts of interest or funding.

© 2014 by Lippincott Williams & Wilkins.