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Indian Journal of Dermatology
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  Official organ of AADV
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DERMATOPATHOLOGY ROUND
Year : 2015  |  Volume : 60  |  Issue : 4  |  Page : 373-377

Primary cutaneous CD8 + CD30 + anaplastic large cell lymphoma: An unusual case with a high Ki-67 index-A short review


Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India

Correspondence Address:
Dr. Jitendra G Nasit
C/4, Suryadeep Society, Near Nutan School, Behind Chankyapuri Society, New Sama Road, Vadodara - 390024, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.160483

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Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a part of the spectrum of CD30 + cutaneous lymphoproliferative disorder, characterized by variable degrees of CD2, CD3, CD4 and CD5 expression by lymphoid cells. PCALCLs with an expression of cytotoxic phenotype (CD8 + ) and cytotoxic proteins are uncommon. Cutaneous CD8 + CD30 + lymphoproliferative lesions are difficult to classify, diagnose and may be the cause of misdiagnose. CD8 + PCALCL must be distinguished from CD8 + mycosis fungoides, lymphomatoid papulosis type D and primary cutaneous aggressive epidermotropic CD8 + T-cell lymphoma. Usually CD8 + PCALCL is an indolent disease with a favorable prognosis, except few cases can show poor outcomes. The high Ki-67 index points toward advanced PCALCL. Treatment modalities include surgical excision, radiotherapy and clinical monitoring. Chemotherapy is reserved for disseminated disease. We report a 59-year-old male presented with rapid development of multiple painful reddish-brown plaques and nodular ulcerative skin lesions over the left thigh region since 2 months. A diagnosis of CD8 + PCALCL with a high Ki-67 index was made on the basis of histology and immunohistochemistry, in co-relation with clinical presentation.


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