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Indurated Plaques on the Legs: Think Lymphoma
Anabella Watts-Santos, Adrian Cuellar-Barboza, Cesar Jair Ramos-Cavazos
1Professor Maira E. Herz-Ruelas, MD, PhD, Universidad Autónoma de Nuevo León, Dermatology Department, Hospital Universitario "Dr. José Eleuterio González." , Av. Madero and Gonzalitos S/N 64460 Mitras Centro, Monterrey, Nuevo León, México; mairaherz@yahoo.com.
Acta Dermatovenerologica Croatica : ADC
|September 3, 2021
Summary
Primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT) is a rare aggressive cancer. Early diagnosis and R-CHOP chemotherapy led to complete remission in a patient, highlighting the importance of prompt treatment for this condition.
Area of Science:
- Dermatology and Oncology: Focuses on rare skin lymphomas.
- Hematology: Addresses B-cell neoplasms and their treatment.
Background:
- Primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT) is a rare and aggressive skin neoplasm.
- Early diagnosis is crucial for preventing fatal outcomes in PCDLBCL-LT.
- PCDLBCL-LT represents approximately 4% of all cutaneous lymphomas and 10% of primary cutaneous B-cell lymphomas.
Observation:
- A 69-year-old woman presented with a 1-month history of an asymptomatic, indurated, erythematous plaque on her left leg.
- Histopathology revealed a dermal infiltrate of large immunoblast-type cells with high mitotic activity.
- Immunohistochemistry showed positivity for CD20, Bcl2, and MUM1, with c-MYC and Ki67 at 20%.
Findings:
- The patient was diagnosed with primary cutaneous diffuse large B-cell lymphoma, leg-type (PCDLBCL-LT).
- Systemic involvement was ruled out by imaging and blood work.
- Treatment with R-CHOP chemotherapy resulted in complete tumor regression within three cycles.
Implications:
- The patient achieved complete remission after six cycles of R-CHOP and remained disease-free for 18 months.
- This case underscores the effectiveness of R-CHOP chemotherapy as a first-line treatment for PCDLBCL-LT.
- Timely diagnosis and appropriate management are essential for improving the prognosis of this aggressive lymphoma.
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