[Deep morphea-type lesions, first manifestations of lymphocytic lymphoma]

The association between scleroderma and lymphoma is uncommon and can sometimes query an fortuitous association. More particular are observations where chronological and histological features show an evident link between a tumorous process and sclerosis.

This case concerns a man 69 years old who was treated for one year for partial subcutaneous sclerosis present on his legs, thighs, fore-arms, and on the upper part of the trunk. No signs were present of visceral involvement evoking a systemic scleroderma and histology showed an intrication of a deep sclerosis, fasciitis and a tumoral lymphoma process. Diagnosis of lymphocytic lymphoma was confirmed. Initiating a chemotherapy (CHOP) allowed for a reduction of the sclerosis which didn't respond to the only corticotherapy.

This observation can be linked to the association of fasciitis and lymphoma identified by Naschitz et al, but is different by: 1) the clinical aspect which correspond more to deep morphea lesions; 2) the histological link between sclerosis and lymphoma. This last point suggest that it is the tumoral population which have induced the sclerosis process linked to the secretion of pro-inflammatory factors. In adverse cases with longer delay between lymphoma and scleroderma this association may be fortuitous.