Pediatric ALK-Negative Anaplastic Large Cell Lymphoma With Recurrent Cutaneous Relapses: Diagnostic Challenges

We present the case of a 10-year-old female with anaplastic lymphoma kinase protein (ALK) negative systemic anaplastic large cell lymphoma (ALCL) with cutaneous manifestations that achieved complete remission after multi-agent chemotherapy. Approximately 6 months after remission, the patient experienced a relapse of ALK-negative ALCL confined exclusively to the skin. Four months after completing salvage therapy, she developed a second isolated cutaneous relapse. This case highlights the diagnostic challenge of distinguishing systemic ALCL from primary cutaneous ALCL and other primary cutaneous CD30+ lymphoproliferative disorders.