Myxoid variant of primary cutaneous anaplastic large cell lymphoma: First 2 cases

Anaplastic large cell lymphoma (ALCL) is a CD30+ T‐cell non‐Hodgkin lymphoma with 2 main clinical presentations: primary cutaneous ALCL (pcALCL) and systemic ALCL (sALCL). While rare cases of myxoid sALCL have been reported, there are no previous cases of myxoid pcALCL reported. We present 2 unusual cases of pcALCL showing prominent collections of dermal mucin closely intermingling with the anaplastic lymphocytes. Patient 1 was a 30‐year‐old woman who presented with ulcerated nodules on her neck, abdomen, chest and shoulders. A systemic lymphoma was excluded by physical examination, positron emission tomography and computed tomography (PET‐CT) scan, as well as by bone marrow biopsy and flow cytometry studies. The patient was closely followed‐up for 10 months without evidence of systemic involvement. The biopsy showed diffuse infiltration of the dermis by a CD2+, CD30+, anaplastic lymphoma kinase (ALK)‐negative ALCL. Patient 2 was a 55‐year‐old woman who presented with a single nodule on her right arm. A systemic lymphoma was excluded by physical examination as well as by a PET‐CT scan. The biopsy showed diffuse and dense lymphoid infiltration of the whole biopsy by a CD3+, CD4+, CD30+, ALK‐negative ALCL. The atypical lymphocytes were intermingled with large amounts of dermal stromal mucin.