Cutaneous B‐cell lymphoma of nails, pinna and nose treated with chlorambucil

Abstract

An 83-year-old woman presented with primary multifocal cutaneous B-cell lymphoma, presenting as discrete nodules on the right pinna and nail-bed of the left middle finger, diffuse swelling and erythema of several other nail-beds of the fingers and toes, with associated pincer nail deformity and rhinophyma. Because of the involvement of several sites not amenable to radiotherapy, she was treated with oral cyclical chlorambucil with good result.

European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas

“…There was a total number of 14 patients with a PCMZL in these studies, all with multifocal skin lesions. 23,25,31,39 The response rate was 100% with a CR in 9 patients (64%) and a partial remission in the other 5 patients. Of the 9 patients with a CR, 3 patients showed relapses (33%), one of whom also with extracutaneous localizations.…”

Primary Cutaneous Marginal Zone B-Cell Lymphoma

“…[15][16][17][18] Apart from a single case report, therapeutic experience with chlorambucil therapy for PCMZL has not previously been published. 19 In 6 (55%) of 11 patients, a complete remission was achieved in a median treatment period of 13 weeks, and only 1 of the 6 patients has since developed a local recurrence of disease. In another 4 patients, a partial remission was observed.…”

B-cell lymphoma mimicking rhinophyma

“…Firstly, the presentation of cutaneous B‐cell lymphoma on the nose with clinical features of rhinophyma, and secondly, the simultaneous occurrence of cutaneous B‐cell lymphoma with cutaneous and nodal T‐cell lymphoma. The clinical appearance of a cutaneous B‐cell lymphoma mimicking rhinophyma has been reported only once before, in a patient who presented with multifocal primary cutaneous B‐cell lymphoma that included nodules on the right pinna and nailbed of the left middle finger, diffuse swelling and erythema of several other nailbeds of the fingers and toes with associated pincer nail deformity, and rhinophyma 1 . Cases of basal cell carcinoma, cutaneous metastases from lung carcinoma and angiosarcoma mimicking rhinophyma can be found in the literature 2,3 …”

“…The clinical appearance of a cutaneous B-cell lymphoma mimicking rhinophyma has been reported only once before, in a patient who presented with multifocal primary cutaneous B-cell lymphoma that included nodules on the right pinna and nailbed of the left middle finger, diffuse swelling and erythema of several other nailbeds of the fingers and toes with associated pincer nail deformity, and rhinophyma. 1 Cases of basal cell carcinoma, cutaneous metastases from lung carcinoma and angiosarcoma mimicking rhinophyma can be found in the literature. 2,3 In a recent review of 398 patients treated for mycosis fungoides over a 7-year period in Israel, 11 patients with mycosis fungoides had B-cell malignancies or Hodgkin's lymphoma, and of these only 4 had skin or subcutaneous involvement of the B -cell tumour.…”