Primary Cutaneous Diffuse B-cell Lymphoma Research Articles

Spontaneous regression of primary cutaneous diffuse large B-cell lymphoma, leg type, with multiple lesions

The prognosis of primary cutaneous diffuse B-cell lymphoma, leg type (PCDLBCL-LT) is poor, especially in patients with multiple lesions, which usually requires systemic chemotherapy as treatment. Here, we report a case of PCDLBCL-LT with multiple lesions and spontaneous regression after biopsy. A 66-year-old man was referred to our clinic with a half-year history of multiple plaques on his back and flank. He had hypertension and had been treated with olmesartan, but he did not have a history of autoimmune diseases, such as rheumatoid arthritis, and no medical history of using immunosuppressive agents. On physical examination, multiple annular to arcuate plaques, up to 4-cm diameter, were found in his back and left flank. Superficial lymph nodes were not palpable. A skin biopsy specimen from the lower and upper back showed bottom heavy dense nodular infiltrates with large atypical cells and many small inflammatory cells. Atypical cells were positive for CD20, CD79a, and bcl-2; partially positive for bcl-6; but did not show staining for MUM-1 or CD10. Small lymphoid cells were positive for CD3, and cytotoxic molecules, such as TIA-1 and perforin, were also positive. Monoclonal immunoglobulin heavy chain rearrangement was detected using Southern blotting. Epstein-Barr virus-encoded sRNA was not detected in the tumour using in situ hybridization. Position emission tomography and enhanced computed tomography did not detect any nodal and visceral involvement. We diagnosed the patient as having PCDLBCL-LT (T2, N0, M0). Most of the lesions, including un-biopsied ones, disappeared after biopsy; however, the plaque on the left flank remained. We performed skin biopsy on the remaining lesion, and its pathology was almost similar to those of the previously biopsied lesions. However, this lesion still remained after biopsy; therefore, it was treated with radiation therapy. The patient remained free from recurrence or distant metastasis for a year.

Une présentation atypique de lymphome cutané B primitif à grandes cellules de type jambe

Primary cutaneous diffuse B-cell lymphoma, leg type, are rare and aggressive tumours frequently affecting elderly patients. We present a case of a 53-year-old woman with an atypical presentation of primary cutaneous diffuse B-cell lymphoma, leg type. Eight years after complete excision of a Jessner-Kanof lymphocytic infiltration on the right shoulder, the patient developed a primary cutaneous diffuse B-cell lymphoma, leg type at the same site. The isolated lesion was treated using local radiotherapy. One year later, the patient presented headache associated with a temporal lesion, and biopsy confirmed a relapse. Cerebral CT scan showed an osteolytic temporal lesion while the other investigations revealed no extracutaneous extension. She was treated with R-CHOP chemotherapy and intrathecal methotrexate due to the osteolytic lesion. The particularity of this case consists in the age of this woman, who was younger than the average, the two atypical localizations on the shoulder, then the temple, and osteolysis, which is not the most frequent extension. Furthermore, to our knowledge, transformation of a Jessner-Kanof lesion into local aggressive primary cutaneous diffuse B-cell lymphoma, leg type, has not been yet described.

A Case of Primary Cutaneous Senile EBV-Related Diffuse Large B-Cell Lymphoma

Epstein-Barr virus is known to be associated with the development of lymphomas in immunosuppressed patients. Recently, age-related immune impairment was recognized as a predisposing factor in the development of Epstein-Barr virus-driven lymphoproliferative processes in elderly patients. We describe the case of an otherwise healthy 84-year-old lady who developed a solitary primary cutaneous diffuse B-cell lymphoma on her leg in which the majority of the malignant cells had Epstein barr early RNA (EBER) and late membrane protein-1 expression, with in situ hybridization and immunohistochemistry, respectively.