PMC9166399_01
An ulcerated red lesion with peripheral erythema on the waist.
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Grossly, the lesion measured 47mm x 41mm in size, with an ulceration of 23mm x 18mm in the center, and the surrounding skin demonstrated irregular pale red erythema (Figure 1).
(A) Extensive infiltration of atypical lymphoid cells in the dermis (H&E, x400). (B) CD30 positivity in PC-ALCL (CD30 immunostain, x400). (C) CD20 negative in PC-ALCL (CD20 immunostain, x400). (D) CD3 negative in PC-ALCL (CD3 immunostain, x400). (E) EBV-encoded RNA (EBER) positive (in situ hybridization, x400).
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The atypical lymphocytes had medium-to-large and oval nuclei (Figure 2A). Immunohistochemistry (IHC) demonstrated diffuse positivity for LCA and CD30 (Figure 2B). The neoplastic cells did not express CD2, CD5, CD20 (Figure 2C), CD3 (Figure 2D), CD4, CD7, CD8, CD56, CK, PAX5, or anaplastic lymphoma kinase (ALK) and the Ki-67 value was over 70%. EBV-encoded RNA (EBER) in situ hybridization (ISH) was positive (Figure 2E).
After radiotherapy, the lesion showed a clear border and the central ulcer healed, surrounded by radiation dermatitis.
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And after 30 times of irradiation, the lesion was crusted and the central ulcer healed (Figure 3), and until now there is no sign of recurrence.