Most primary cutaneous anaplastic large-cell lymphomas are ALK–,121 and ALK expression in the skin in the majority of skin lesions indicates systemic disease.116 However, as shown in a Workshop case of a 26-year-old male, rare cases of well-documented primary cutaneous anaplastic large-cell lymphoma are ALK+ (Figure 8).122,123 Conversely, it should also be remembered that ALK negativity in the skin does not exclude systemic disease, as 20–60% of anaplastic large-cell lymphomas can be ALK–. The gene discussed is ALK; the disease is anaplastic large cell lymphoma.