Precursor B-cell lymphoblastic lymphoma involving the skin

Area of Science:

• Hematology
• Oncology
• Dermatopathology

Background:

• Precursor B-cell lymphoblastic lymphoma (B-LBL) is a rare hematologic neoplasm.
• Typically affects younger individuals, presenting as head and neck nodules.
• Rarely diagnosed in elderly populations.

Observation:

• A 65-year-old male presented with multiple, 2-month-old skin nodules on the scalp, neck, and arm.
• Histopathology revealed diffuse dermal and subcutaneous infiltrates of medium-sized lymphoid cells.
• A characteristic starry-sky pattern was noted on microscopic examination.

Findings:

• Immunohistochemical analysis confirmed the lymphoid cells expressed precursor B-cell markers.
• The findings were consistent with precursor B-cell lymphoblastic lymphoma.
• The patient received three cycles of combination chemotherapy.

Implications:

• This case underscores the possibility of B-LBL in older adults, challenging typical age demographics.
• Highlights the importance of considering rare neoplasms in elderly patients with cutaneous manifestations.
• Further research may elucidate B-LBL's behavior and optimal treatment in the elderly population.