Relapsed lymphoma mimicking venous ulcer: A case report

Area of Science:

• Oncology
• Dermatology
• Hematology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
• Lymphoma typically does not present with cutaneous ulceration.
• Chronic non-healing leg ulcers can have diverse underlying etiologies.

Observation:

• A 73-year-old male with a history of DLBCL presented with a chronic, non-healing leg ulcer.
• The patient had a prior diagnosis of DLBCL six years earlier, treated successfully with R-CHOP and intrathecal methotrexate.
• The leg ulcer was superimposed on a background of varicose veins and recurrent venous ulcers.

Findings:

• The relapsed DLBCL manifested as an atypical cutaneous ulceration.
• Treatment with rituximab combined with chemotherapy led to complete healing of the leg ulcer.
• This case underscores the importance of considering unusual presentations in relapsed lymphoma.

Implications:

• This case highlights the potential for DLBCL to present with cutaneous manifestations, even as a chronic ulcer.
• Early recognition and appropriate treatment of atypical lymphoma presentations are crucial for patient outcomes.
• Further research may elucidate the mechanisms behind cutaneous lymphoma ulceration and its treatment response.