Early diagnosis and surgical treatment of primary cutaneous marginal zone B-cell lymphomas of the face in an Asian patient

Abstract

Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is an uncommon type of malignant lymphoma that mainly occurs in the trunk and upper extremity, with less frequent incidence observed on the head. Herein, we report the early diagnosis and treatment of a rare case of facial PCMZL in an Asian patient. A 51-year-old man presented with masses on the forehead and nose tip, which he had incidentally discovered 2 months previously. The masses appeared as a papule on the forehead and a patch on the nose. There were no signs of infection or bleeding, and the patient reported no other symptoms. After complete surgical excision, PCMZL was diagnosed based on the permanent biopsy. The histopathological findings revealed lymphoid aggregations with multifocal granulomas. Further treatment and follow-up were conducted at the hematology and oncology department. Despite its rarity in Asian populations, cutaneous lymphoma should be included in the differential diagnosis of facial masses. Early diagnosis and treatment based on a physical examination, imaging study, and excisional biopsy are important for a favorable prognosis.

T-Cell-Rich Angiomatoid Polypoid Pseudolymphoma: A Case Report and Comparison With Key Differential Diagnoses

“…Monoclonal T-cell receptor (TCR) rearrangement should not be seen in TRAPP. PCSM-TCLPD has small- to medium-sized pleomorphic CD4+/CD8- lymphocytes and PD1+ cells in clusters [ 18 ], which are not expected in TRAPP. The prominent vascular component in TRAPP is not a feature of cutaneous lymphomas or lymphoproliferative disorders.…”

“…radiotherapy [9] Benign [12]; recurrence is common (up to 60-80%) [12]; death is rare [ Local radiation therapy: 99% complete response rate [16]; 30% relapse rate [16]; 5-year survival rate >95% [2,9] PCSM-TCLPD Mostly adults [2] Single or multiple pink or violet papules, plaques, and tumors [2]; common sites: head and neck [2,18] Nodular or diffuse dermal infiltrate of small-to medium-sized lymphocytes; can have neutrophils, eosinophils, and plasma cells [2] CD3+, CD4+, CD8-, CD30- [18]; monoclonal TCR rearrangements [2];…”

“…grouped PD-1 expression in follicular helper T-cells [18] Surgical excision; radiotherapy; intralesional corticosteroids; chemotherapy [18] High cure rates from excision and radiotherapy [18] CLH Mostly young adults [1,11]; female predominance [1,9] Single or multiple red-brown or violet papules or nodules [9,11]; common sites: head and neck [1,8,11] Nodular or diffuse dermal infiltrate with lymphoid follicles and reactive germinal centers [9,11]; admixed histiocytes, plasma cells, and eosinophils [9] Predominance of T-cells, B-cells, or a near equal mixture of both; reactive germinal centers: BCL-6+, CD10+, BCL-2- [11] Corticosteroids; surgical excision; radiotherapy; immunosuppressants [11] Benign [1,11]; lesions may resolve spontaneously after months or years [9]; treatment of underlying disease or instigating agent can be curative [11] TABLE 1: Differential diagnosis of TRAPP.…”