Primary cutaneous CD5+ marginal zone B‐cell lymphoma resembling the plasma cell variant of Castleman's disease

Abstract

Marginal zone B-cell lymphoma (MZBL) is occasionally associated with prominent plasma cell differentiation. However, MZBL rarely exhibits histological features that resemble plasmacytoma arising from a localized plasma cell variant of Castleman's disease (PCCD). We here report a histologically similar case that was associated with primary cutaneous tumor. The patient was a 57-year-old woman with a 5-year history of cutaneous nodules. Histologically, a prominent proliferation of plasma cells occupied the interfollicular area of the central portion of the cutaneous tumor, whereas various numbers of CD5+ centrocyte-like (CCL) cells, which were arranged in a marginal zone distribution pattern, occupied the peripheral region of the tumor. The majority of the lymphoid follicles had atrophic or regressive germinal centers resembling hyaline-vascular Castleman's disease. CCL cells were observed to have colonized a few of the lymphoid follicles. Immunohistochemistry revealed that these cells had a monotypic intracytoplasmic kappa chain. Without treatment, the patient was quiescent, but 2 years later, there was a transformation to the large cell type. These observations suggest that MZBL needs to be distinguished from PCCD, and that untreated cutaneous MZBL may undergo a high-grade blastic transformation similar to other indolent lymphoproliferative disorders.

CD5-positive mucosa-associated lymphoid tissue (MALT) lymphoma: a clinicopathologic study of 14 cases

“…Scattered cases of CD5+ MALT lymphoma have been reported in small numbers [2][3][4][5][6][7][8][9][10][11][12][13][14]. Some authors have suggested that CD5 expression is associated with an aggressive clinical course marked by widespread dissemination [2,9,11], but others have reported CD5 expression in localized, otherwise typical cases of MALT lymphoma [3,4,8,10,13].…”

Unicentric mixed variant Castleman disease associated with intrabronchial plasmacytoma

“…B cells are known to be characterized by CD5 expression in the expanded mantle zones of CD. In contrast, CD5 positivity is unusual in MALT lymphomas except for some rare cases [32], that can even closely mimic CD [33]. For establishing the accurate diagnosis, careful histopathologic examinations are needed, immunohistological examinations and immunologic gene rearrangement analysis can be helpful in the differentiation.…”

CD5-positive marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the lung

“…Kubota et al [9] reported 3 case of CD5-positive MALT lymphoma of orbit with autoantibodies. Tsukamoto et al [10] reported a case of cutaneous CD5-positive MALT lymphoma resembling the plasma cell variant of Castleman's disease. Wenzel et al [11] reported a case of CD5-positive MALT lymphoma of the conjunctiva with early dissemination and aggressive clinical behavior.…”