Rapid Progression of Cutaneous Large B-Cell Lymphoma During Hyperbaric Oxygen Therapy: A Case Report

We present a case of a patient with a history of chronic lymphocytic leukemia (CLL) and cutaneous B-cell lymphoma of the right leg. She had previously received radiation treatment to the affected area and subsequently developed radiation fibrosis with two non-healing ulcerations at the previous tumor sites. A biopsy revealed spongiotic and sparse superficial perivascular dermatitis. Due to poor wound healing, adjunctive hyperbaric oxygen (HBO₂) therapy was initiated. However, shortly after beginning HBO₂ treatments, the wounds worsened. Repeat biopsies were performed, and the new areas were consistent with cutaneous large B-cell lymphoma. Consequently, HBO₂ therapy was discontinued, and aggressive chemotherapy/immunotherapy was initiated. We recommend that patients with a history of cutaneous B-cell lymphoma be closely monitored for signs of tumor recurrence or disease worsening if they are to undergo adjunctive hyperbaric oxygen therapy.