Tumeur évoluée du tronc d’origine lymphomateuse

Abstract

Malignant lymphomas are a group of cancers that arise in the lymphoid tissue, in the lymph nodes or in extranodal sites due to neoplastic lymphocytic cell transformation. Within this group, malignant non-Hodgkin lymphomas are distinctive. We report a case of diffuse advanced and extremely aggressive malignant cutaneous non-Hodgkin lymphoma. The study involved a 30-year old patient, driver, married and father of one child, followed-up in the Department of Hematology and Oncology for 2 years due to malignant non-Hodgkin lymphoma diagnosed on the basis of axillary and inguinal polyadenopathies. The patient underwent 13 chemotherapy sessions. He was admitted to the Department of Plastic, Cosmetic and Burn Surgery at the University Hospital Mohammed VI in Marrakech with skin involvement of his lymphoma manifesting as an advanced left latero-thoracic tumor rapidly increasing in size. On clinical examination, his general condition was quite good. It showed voluminous left latero-thoracic mass adherent to its deeper structure with ipsilateral axillary shield. Partial biopsy was performed. Anatomo-pathological examination confirmed the diagnosis of diffuse malignant large B-cells non-Hodgkin's lymphoma. Immunohistochemical and genetic study was not performed. Serology tests were negative. Serial Computed Tomography (CT) scan showed voluminous left antero-lateral predominantly axillary and thoracic ganglionic mass made of confluent lymph nodes, with persistence of peripheral lymph nodes, skin ulcers and necrotic areas measuring 30cm in diameter. In our Hospital, the patient underwent wide tumor resection, then coverage with a split-thickness skin, thus reducing tumor volume and ensuring better patient's comfort. When the patient started healing, he was referred to the Department of Hematology and Oncology for complementary treatment.