Diffuse large B-cell lymphoma presenting with extensive cutaneous infiltration.

Abstract

We report a case of systemic diffuse large B-cell lymphoma presenting with extensive infiltration of the skin. A 56-year-old woman presented with a two-month history of pruritic erythematous plaques and nodules over the neck, trunk and upper limbs. She also had night sweats, weight loss, lethargy and reduced effort tolerance. Systemic examination revealed a pale, ill appearance with hepatosplenomegaly and lymphadenopathy. Blood investigations showed pancytopenia (haemoglobin 6.3 g/dL, total white cell count 3.0 × 10(9)/L, platelet count 138 × 10(9)/L) with a few suspicious mononuclear cells and a mildly elevated lactate dehydrogenase level (478 U/L). Skin biopsy demonstrated diffuse sheets and nodular infiltrates of CD20 and CD79a positive neoplastic cells in the dermis and subcutis. Computed tomography revealed multiple cervical, axillary, mediastinal, para-aortic and mesenteric lymph nodes. Bone marrow aspiration and trephine biopsy confirmed marrow involvement by non-Hodgkin's lymphoma. The patient was treated with chemotherapy, which resulted in resolution of the skin lesions.

• Authors: Norashikin Shamsudin, Choong Chor Chang
• Journal: Singapore medical journal (Singapore Med J) Vol. 53 Issue 9 Pg. e198-200 (Sep 2012) ISSN: 0037-5675 [Print] India
• PMID: 23023915 (Publication Type: Case Reports, Journal Article)

Topics

• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (complications, drug therapy, pathology)
• Middle Aged
• Pancytopenia (etiology)
• Pruritus (etiology)
• Skin Neoplasms (complications, drug therapy, pathology, secondary)