Scalp tumour as a sign of systemic B-cell lymphoma.
An 86-year-old man presented with a painful reddish tumour on the scalp with a 3-month history, mental confusion with recent onset and lymphadenopathies. Histological examination of the lymph node and cutaneous lesion revealed a dense infiltrate of atypical and large B cells. There was no evidence of bone marrow invasion. According to REAL (Revised European-American Classification of Lymphoid Neoplasms), this lymphoma was considered as a diffuse large B-cell lymphoma with concurrent cutaneous and nodal involvement. Cerebral computerized tomography (CT) scan showed bone and dura mater invasion in the right parieto-occipital region with collapse of lateral ventricle. The patient was submitted to systemic chemotherapy with cyclophosphamide, vincristine and prednisolone (CVP). There was a good response with regression of the cutaneous lesion, but the patient died after the third cycle. We point out the unusual clinical presentation and aggressive behaviour of this lymphoma.
Magina
S
S
Departments of Dermatology and Venereology and Internal Medicine, Faculty of Medicine, Hospital de S. João, Alameda Prof. Hernani Monteiro, 4200 Porto, Portugal. miguelsofia@mail.telepac.pt
Mesquita-Guimarães
J
J
Resende
C
C
Bello
M
M
Dias
C
C
D000368:Aged; D000369:Aged, 80 and over; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008297:Male; D009361:Neoplasm Invasiveness; D012535:Scalp; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy