Cutaneous Anaplastic T-Cell Lymphoma Mimicking a Small Abscess: A Case Report

TL;DR

A case report describes a non-healing ulcer in a man that was initially thought to be an infection but was later diagnosed as a rare type of T-cell lymphoma.

Contribution

Highlights the importance of considering malignancy in non-healing ulcers and the necessity of biopsy for accurate diagnosis.

Findings

A non-healing ulcer in a 39-year-old man was found to be a possible cutaneous anaplastic T-cell lymphoma.

The ulcer was initially misdiagnosed as an infection but biopsy revealed a malignant neoplasm positive for CD30 and CD45.

The case emphasizes the need for a broad differential diagnosis and early biopsy in persistent ulcers.

Abstract

Non-healing ulcers display a noteworthy demonstrative challenge for clinicians. While often attributed to common causes like infections, these persistent wounds can occasionally mask a more sinister underlying condition: malignancy. This case report presents a 39-year-old Indian man with a non-healing ulcer on his right gluteal region. Despite initial treatments for a presumed bacterial infection, the ulcer persisted. Biopsy ultimately revealed a malignant neoplasm of possible hematopoietic origin, positive for CD30 and focally positive for CD45. Further investigations, including MRI, FNAC, and X-rays, were indicative of lymphoma.

Non-healing ulcers present a challenge due to diverse etiologies. A thorough understanding of potential causes, including infectious, vascular, autoimmune, and malignant etiologies, is crucial for navigating the diagnostic process. This case highlights the critical role of maintaining a broad differential diagnosis for non-healing ulcers and the importance of a biopsy in reaching a definitive diagnosis. Early recognition of malignancy in such cases is essential for optimal patient management. This case underscores the importance of considering malignancy in patients with persistent ulcers and performing biopsies for a definitive diagnosis. While the initial presentation mimicked an infectious process, the biopsy revealed a possible cutaneous anaplastic T-cell lymphoma. Further investigations are necessary to definitively classify the specific lymphoma subtype and guide further treatment decisions.

Figures