Atypical Ulcerated Cutaneous Presentation of Diffuse Large B-Cell Lymphoma: A Case Report

Diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy that typically presents with nodal disease, while cutaneous involvement is uncommon and may lead to delayed diagnosis. We report the case of a 48-year-old man presenting with a rapidly enlarging ulcerated mass on the shoulder, complicated by hemorrhage and severe anemia. The lesion had progressed over six months and was associated with significant unintentional weight loss. Imaging revealed a necrotic soft tissue mass, and histopathological examination confirmed diffuse large B-cell lymphoma, centroblastic subtype, with a high proliferative index (Ki-67 70-80%). The patient's clinical course was rapidly progressive, and he died before complete staging, including positron emission tomography (PET) imaging, could be performed. This case highlights the importance of early biopsy of atypical or rapidly progressive cutaneous lesions, as delayed recognition of extranodal presentations of aggressive lymphomas may adversely impact patient outcomes.