A case of a primary cutaneous diffuse large B‐cell lymphoma, leg type

Abstract

A case of a primary cutaneous diffuse large B-cell lymphoma, leg type Dear Editors, An 82 year-old woman referred to our department for violaceous, multiple, and confluent nodules arised on her left leg 1 month before. The lesions were partially ulcerated and no clinical lymphadenopathy was noticed (Figure 1A,B). No symptoms, such as pain or burning sensations, were reported by the patient. She has been suffering from unilateral lymphedema of the left inferior limb, which occurred 1 year ago. Regarding her past medical history, she referred previous surgery for vulvar squamous cell carcinoma (2015), and she has been treated for heart failure with beta-blockers, angiotensin-converting enzyme-inhibitor, and diuretics. An incisional biopsy was planned in order to rule out malignancy. The histological examination with haematoxylin and eosin staining showed a diffuse proliferation of pleomorphic, medium to large lymphocytes in the deep dermis with mitosis, too. No alteration in the corresponding epidermis was noticed (Figure 2A-D). Immunohistochemistry was positive for CD20, Bcl-2, Bcl-6, and ki-67 (Figure 2E-H). All the results led to the diagnosis of a primary cutaneous

Unilateral lower extremity lymphedema as a first symptom of primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT)

“…Thirteen such cases were described in the literature [19]. The time between the occurrence of lymphedema and the development of PCDLBCL-LT skin lesions ranged from 40 years to only 1 year [19,20]. In general, long-standing congenital or acquired lymphedema is a well-known risk factor for many other malignancies, including lymphangiosarcoma, squamous cell carcinoma, malignant melanoma, and Kaposi's sarcoma [18].…”