Primary Cutaneous Spindle Cell B-Cell Lymphoma of Follicle Origin Mimicking Acne Rosacea

Abstract

Primary cutaneous spindle cell lymphoma is a unique morphologic variant of cutaneous B-cell follicle center lymphoma characterized by a prominent population of spindle-shaped, medium, and large B lymphocytes with a poorly formed storiform pattern.We report a case of a 35-year-old woman who presented with a well-defined erythematous plaque with 2 nodular, nontender nonscaling nonulcerated lesions on her right cheek mimicking acne rosacea. Microscopic examination revealed a tumor mainly centered in the reticular dermis and mostly composed of spindle-shaped large B lymphocytes exhibiting bizarre shapes with "boomerang-like" or "spermatozoa-like" appearance. The immunohistochemical staining demonstrated neoplastic lymphocytes positive for CD20, CD79α, and BCL-6, and negative for CD3, CD43, CD10, BCL-2, and MUM-1. These results supported the diagnosis of a follicle center B-cell lymphoma with spindle cells.Although this rare variant of primary cutaneous B-cell lymphoma is not included in the recent WHO-EORTC classification, the rarity of this tumor and its unique morphologic appearance frequently leads to misdiagnosis and delays its treatment.

Nichtepitheliotropes malignes B-Zell-Lymphom mit atypischer Spindelzellmorphologie bei einem Weimaraner

“…Der erste Bericht über fünf Patienten mit einem kutanen B-Zell-Lymphom, dessen lymphatische Zellen eine zum Teil spindelzellige Morphologie aufwiesen, stammt aus dem Jahr 2000 (2). Seither wurden wenige weitere Fälle veröffentlicht (5,9,10,(18)(19)(20)(21).…”

« Malignant » Rosacea as a sign of systemic marginal zone lymphoma

“…A. Lamoureux, 1 B. Vergier, 2,3 G. Fidelin-Ferrati, 4 P. Hans, 5 N. Milpied, 6 M. Beylot-Barry 1,2, *…”

“…1 An increased association of B-cell chronic lymphocytic leukaemia (B-CLL) and melanoma, possibly related to an underlying immunologic defect, has been previously reported. 5 We still have limited data on the management of advanced stages of cancer duplicities.…”

Cutaneous spindled follicle center cell lymphoma with abundant mucin: A diagnostic pitfall

“…While the rare spindle cell variant of PCFCL usually has the same immunohistochemical profile as PCFCL, it is histopathologically characterized by a prominent population of spindle‐shaped cells with scant cytoplasm admixed with centrocytes . Such unusual presentations of PCFCL closely mimic other dermatologic lesions, which often delay accurate diagnosis and treatment . Here we present a case of a primary cutaneous spindle cell B‐cell lymphoma of follicle origin that presented a diagnostic challenge due to abundant mucin deposition within the tumor, disguising it as a soft tissue neoplasm.…”

“…[4][5][6][7][8] Such unusual presentations of PCFCL closely mimic other dermatologic lesions, which often delay accurate diagnosis and treatment. 9,10 Here we present a case of a primary cutaneous spindle cell B-cell lymphoma of follicle origin that presented a diagnostic challenge due to abundant mucin deposition within the tumor, disguising it as a soft tissue neoplasm.…”