Primary Cutaneous Anaplastic Large-cell Lymphoma With Marked Spontaneous Regression Of Organ Manifestation After Sars-cov-2 Vaccination
Gambichler, T., Boms, S., Hessam, S., Tischoff, I., Tannapfel, A., Lüttringhaus, T., Beckman, J., & Stranzenbach, R. (2021). Primary cutaneous anaplastic large-cell lymphoma with marked spontaneous regression of organ manifestation after SARS-CoV-2 vaccination. The British journal of dermatology, 185(6), 1259–1262. https://doi.org/10.1111/bjd.20630
View Original Source →Abstract
Primary cutaneous anaplastic large cell lymphoma (pcALCL) belongs to the primary cutaneous CD30+ T cell lymphoproliferative disorders.1 Systemic involvement is relatively rare and rather confined to the regional lymph nodes.1 We describe a patient with recurrent pcALCL and diffuse lung manifestation which spontaneously regressed after one SARS-CoV-2 vaccination. We report a 57-year-old male patient with a 10-year history of biopsy-proven (CD30+, CD3+, CD4+, ALK-, clonal T cell receptor gamma chain rearrangement) pcALCL with frequent local relapses predominantly affecting his scalp and neck.
Case Details
Disease Location
Lymph nodes, lungs
Personal Characteristics
57-year-old male. 10-year history of biopsy-proven [CD30+, CD3+, CD4+, anaplastic lymphoma kinase (alk)-, clonal t-cell receptor gamma-chain rearrangement] (pcalcl) affecting his scalp and neck. History of suspicious waning and waxing cervical lymph nodes (partly biopsy-proven) over the last 5 years. Pretreatments included methotrexate, brentuximab, gemcitabine and radiotherapy. He achieved remission after radiotherapy.
Clinical Characteristics
1 month after remission, he presented with a pathologically enlarged cervical lymph node. CT showed innumerable bilateral pulmonary nodules that were suspicious for new pcalcl manifestation or second malignancy a lung wedge resection was performed. Pathology showed the same pattern observed in biopsies of skin lesions 5 years and 9 years previous. The patient received his first covid-19 vaccination (comirnaty", biotech/pfizer, mainz, germany).
Remission Characteristics
1 week after vaccination and a few days before the initiation of brentuximab therapy, the patient noticed shrinking of the suspicious cervical lymph node, which was confirmed by ultrasound. Thoracic CT revealed an almost complete resolution of the diffuse lung lesions.
Treatment & Mechanisms
Proposed Remission Mechanisms
Sars-cov2 vaccine was the causal factor of the marked spontaneous regression
Clinical Treatment
Biopsy covid-19 vaccine
Non-Clinical Treatment
None reported