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.
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
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Magina
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Mesquita-Guimarães
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Resende
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Bello
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Dias
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