Diffuse skin hyperpigmentation in CD30+ lymphoproliferation

• Published in: Annals of Saudi medicine Vol. 32; no. 3; pp. 318 - 320
• Main Authors: Prka, Zeljko, Tomasovic-Loncaric, Cedna, Pejsa, Vlatko, Nevajda, Branimir, Kusec, Rajko
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Medknow Publications and Media Pvt. Ltd 01-05-2012; KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTRE; King Faisal Specialist Hospital and Research Centre
• Subjects: Abdomen; Biopsy; Case Report; Disease; Endocrine system; Fungal infections; Hematology; Hospitals; Humans; Hyperpigmentation - etiology; Hyperpigmentation - pathology; Immunoglobulins; Internal medicine; Ki-1 Antigen; Laboratories; Lymphatic diseases; Lymphatic system; Lymphoma; Lymphoma, Large-Cell, Anaplastic - complications; Lymphoma, Large-Cell, Anaplastic - diagnosis; Lymphoma, Large-Cell, Anaplastic - pathology; Male; Medicine; Middle Aged; Morphology; Proteins; Skin; Skin Neoplasms - complications; Skin Neoplasms - diagnosis; Skin Neoplasms - pathology; New York; Italy; United States > US; Croatia
• ISSN: 0256-4947; 0975-4466
• DOI: 10.5144/0256-4947.2012.318

CD30+ T-cell lymphoproliferative disorders (LD) comprise two main groups of diseases: CD30+ LD of the skin and systemic anaplastic large cell lymphoma (ALCL). The main feature of these disorders is the expression of CD30. We present a patient with an unusual clinical presentation of CD30+ lymphoproliferative disease in a 54-year old Caucasian male who presented with generalized lymphadenopathy and pronounced skin hyperpigmentation. In the lymph nodes and skin, CD30+ lymphoproliferation (ALCL) was diagnosed. The Prussian blue staining identified that the pigment responsible for the skin color was hemosiderin. Chemotherapy was started but the patient's condition progressively worsened and he died a week after the first cycle. The complete color transformation of the entire skin due to hemosiderin accumulation is, to the best of our knowledge, the first reported observation in a CD30+ lymphoproliferation/ALCL patient. We speculate that hemosiderin-loaded macrophages resulted from the paraneoplastic process by some still unknown mechanism.