Background: Anaplastic lymphoma kinase (ALK) expression has not been described in neutrophil-rich anaplastic large cell lymphoma (NR-ALCL).
Case report: A 12-year old female with a 4-weeks history of a non-resolving bump over the forehead resulting from injury, was diagnosed of stage IE cutaneous T-cell lymphoma, and radiation was employed. Shortly after completion of therapy, there was progress of the disease on the soft tissue of the right hand, and bone marrow involvement was also found. A fine-needle aspiration of the hand mass was performed, and a diagnosis of CD30+/ALK+ NR-ALCL, was rendered.
Methods: We studied the morphological characteristics of CD30+/ALK+ NR-ALCL using histological methods. A panel of antibodies were used to establish diagnosis and subtyping. In addition EBV status and molecular cytogenetics were determined.
Conclusions: ALK-ALCL arising in the skin represents a single disease with a broad spectrum of morphology; clinicians and pathologists should be aware of this neutrophil-rich (NR) variant with aggressive clinical presentation.