Abstract
A 95-year-old man came with violaceous nodular skin lesions of the left shin. The lesions were not painful or pruritic but progressed rapidly over the 3 months. Fever, night sweats, weight loss, and other systemic symptoms were absent. Shave biopsy of the lesion revealed the cells negative for CD20 but positive for BCL2, BCL6, FOX-P1, and CD10. PET/CT showed high uptake in the left leg and a sizeable hypermetabolic lymph node in the left pelvis. The patient was started on rituximab treatment as a single agent. This report highlights some of the diagnostic and treatment difficulties in CD20 negative lymphomas and the importance of a multidisciplinary approach in those cases.
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