血液疾患と輸血ジャーナル

概要

Primary Cutaneous Diffuse Large B-Cell Lymphoma of the Leg: Apropos of a Fatal Case

Martinez Peinado Carmen, Valenzuela Salas Ignacio, Nogueras Morillas Paloma, Aneiros Fernández José, Blasco Morente Gonzalo, Garrido Colmenero Cristina, Martínez García Eliseo and Puerta Puerta José Manuel

Primary cutaneous lymphomas are a heterogeneous group of lymphoproliferative disorders with skin involvement and no evidence of systemic disease at the time of diagnosis. Since the 1980s, primary cutaneous B-cell lymphomas have been considered a specific group of lymphomas. Large B-cell lymphoma of the leg accounts for 2% of primary cutaneous lymphomas, but its classification has been under debate over the past few years. It was recognized as an independent entity in the 2004 WHO-EORTC classification of cutaneous lymphomas. It is clinically characterized by erythematous nodules or tumors, frequently unilateral, on the distal third of the lower limbs in patients of advanced age. The clinical behavior is generally indolent, and cases of extracutaneous spread are infrequent but have an intermediate prognosis. We report the case of an 85-yr-old man who presented with a six-week history of asymptomatic indurated erythematous plaque on the left leg that had rapidly and progressively increased in size. Histological analysis revealed a CD20- and bcl-2-positive large cell lymphoid infiltrate throughout the dermis. The extension study was normal. Chemotherapy was started with the R-CHOPregimen, and the patient evidenced a good clinical response but died after two months.