Salmon-Colored and White Areas on Dermoscopy as Supportive Findings in the Diagnosis of Primary Cutaneous Marginal Zone Lymphoma.

Giovanni Biondo,Cesare Massone,Carlotta Pastorino,Simona Sola

doi:10.5826/dpc.0901a14

Abstract

Salmon-Colored and White Areas on Dermoscopy as Supportive Findings in the Diagnosis of Primary Cutaneous Marginal Zone Lymphoma.

Highlights

Neoplastic cells stained positive for CD20 and CD79a; cells stained negative for Bcl-6, Bcl-2, CD5, and CD10; reactive T lymphocytes were CD3+
Mascolo et al described the dermoscopic features of 10 primary cutaneous B-cell lymphoma (PCBCL) cases, observing white circles with a salmon-colored area in 9/10 cases, scales in 7/10 cases, and arborizing vessels or a polymorphous vascular pattern in 5 and 2 cases, respectively [2]
Our observation confirms that a salmon-colored area upon dermoscopy is typical even if not exclusive of PCBCL. It brings to mind the orangish-yellowish areas observed in granulomatous dermatoses such as sarcoidosis, lupus vulgaris, and granulomatous rosacea, where linear branching vessels are seen [6,7], while granuloma annulare shows peripheral structureless reddish-yellowish-orange areas with variable blurry vessels [8,9]

Summary

Introduction

Dermoscopy can be a useful tool to help clinicians in the diagnosis of cutaneous B-cell lymphomas. A 61-year-old man presented with an irregularly growing erythematous plaque measuring 28 × 35 mm, which had appeared on the left thigh a few months before (Figure 1A). He was otherwise healthy and could not recall an arthropod bite or a trauma in the same area. Ing to the subcutaneous fat composed of reactive lymphoid follicles surrounded by a diffuse infiltrate composed by small to medium sized cells (marginal zone cells). Plasma cells (at the margins of the infiltrate), lymphoplasmacytoid cells, small reactive lymphocytes, and occasional eosinophils were observed. Neoplastic cells stained positive for CD20 and CD79a; cells stained negative for Bcl-6, Bcl-2, CD5, and CD10; reactive T lymphocytes were CD3+. Following WHO criteria [1], primary cutaneous marginal zone lymphoma (PCMZL) was diagnosed

Discussion

Findings

Head and neck