INTRODUCTION
Primary cutaneous anaplastic large cell lymphoma (pc-ALCL) is a CD30+ subtype of cutaneous T-cell lymphoma (CTCL). It typically presents as one or more nodules on the skin with a dermal infiltrate of >75% CD30+ lymphocytes.1
CASE REPORT
A 77-year-old Caucasian female presented for evaluation of a pink patch and papule on her forehead that appeared seven months prior. Examination revealed a 5 by 2 cm scaly pink patch on the right superior forehead with a 1 cm pink papule on the right medial forehead (Figure 1a). Lesional biopsy showed dense atypical lymphocytic infiltrate composed of medium to large cells with moderate amounts of eosinophilic cytoplasm, hyperchromatic or vesicular nuclei with irregular nuclear contours, conspicuous nucleoli, and frequent mitotic figures within the dermis without a Grenz zone, with prominent involvement of epidermis (Figures 2a & 2b). Atypical cells in the epidermis and dermis were diffusely positive for CD3, CD4 and CD30 (Figures 2c & 2d), and negative for CD8, CD20, and ALK1. CD7 was negative in epidermotropic cells. Together, these findings led to a diagnosis of pc-ALCL.