Affiliation:
1. School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
2. Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15261-2109, USA
Abstract
Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), is a rare and aggressive variant of primary cutaneous lymphoma that typically expresses B cells as well as MUM1/IRF4, BCL2, and FOXP1, whereas BCL6 may be present or undetectable. We present a case of CD5+ PCDLBCL-LT presenting as a 6 mm pink-bluish nodule on the mid-left thigh, which was concerning for basal cell carcinoma. The histological examination reveals the presence of an intradermal proliferation of large, atypical CD5+, CD20+ BCL2+, BCL6+, MUM-1+, and Cyclin-D1+ lymphocytes in a nodular, diffuse interstitial and perivascular distribution. Because the patient presented with a small, single nodule, the systemic treatment of multiagent chemotherapy was avoided and localized electron beam radiation therapy with rituximab was initiated instead, achieving complete response. Early identification of PCDLBCL-LT is key for maximal therapeutic benefit and prognosis; it is important to consider PCDLBCL-LT on the differential when evaluating small, single nodules on the lower extremities of elderly patients.
Reference15 articles.
1. Primary cutaneous B-cell lymphomas: Part II. Therapy and future directions;Querfeld;J. Am. Acad. Dermatol.,2013
2. Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL), leg-type and other: An update on morphology and treatment;Paulli;G. Ital. Dermatol. Venereol.,2012
3. Cutaneous lymphomas: An update. Part 2: B-cell lymphomas and related conditions;Kempf;Am. J. Dermatopathol.,2014
4. Cutaneous B-cell lymphomas—Pathogenesis, diagnostic workup, and therapy;Nicolay;J. Dtsch. Dermatol. Ges.,2016
5. WHO-EORTC classification for cutaneous lymphomas;Willemze;Blood,2005