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A primary cutaneous multi-lobed B-cell lymphoma
L Vaillant1, A De Muret, C Monegier Du Sorbier
1Department of Dermatology, C.H.U. Trousseau, Tours, France.
Insights
A rare multi-lobed non-Hodgkin's lymphoma (NHL) variant presented as a primary cutaneous B-cell lymphoma. This case highlights the importance of recognizing this distinct entity with favorable chemotherapy response.
Area of Science:
- Oncology
- Hematology
- Dermatopathology
Background:
- Non-Hodgkin's lymphoma (NHL) encompasses diverse subtypes, with multi-lobed NHL recently identified as a distinct variant.
- Primary cutaneous lymphomas involve the skin without systemic dissemination at diagnosis.
Observation:
- A patient presented with a scalp nodule and associated bone defect on skull X-ray.
- Immunophenotyping confirmed a B-cell proliferation, and histological examination revealed B-lymphocytes resembling centroblasts.
- No other extra-cutaneous localizations were detected.
Findings:
- This case represents the first documented instance of primary cutaneous multi-lobed B-cell NHL, confirmed by immunophenotyping.
- The tumor exhibited characteristics of prominent extra-nodal involvement and large lymphoid cells with multi-lobed nuclei.
- The patient showed a positive response to chemotherapy.
Implications:
- The findings underscore the significance of multi-lobed NHL as a clinico-anatomical entity, particularly its potential for primary cutaneous presentation.
- Recognizing this variant is crucial for accurate diagnosis and appropriate therapeutic strategies, given its distinct biological features and treatment response.
- Further research into multi-lobed NHL, encompassing both T-cell and B-cell subtypes, is warranted to fully elucidate its pathogenesis and clinical behavior.
Abstract:
Multi-lobed non-Hodgkin's lymphoma (NHL) has recently been recognized as a NHL variant. A patient presented with a scalp nodule which, upon skull X-Ray, was seen to be associated with a bone defect. Immunophenotyping clearly demonstrated that this was a B-cell proliferation. Histologically the B-lymphocytes were closely related to centroblasts. There were no other extra cutaneous localizations. The present report emphasizes the importance of this clinico anatomical entity which shows prominent extra-nodal involvement, large lymphoid cells with multi-lobed nuclei and a good response to chemotherapy. Multi-lobed NHL may be a T-cell lymphoma, or a B-cell lymphoma closely related to centroblastic NHL. Although multi-lobed lymphomas have a predilection for cutaneous localizations, our case is the first primary cutaneous multi-lobed B-NHL, proven by immunophenotyping.