Primary cutaneous CD5+ marginal zone B-cell lymphoma resembling the plasma cell variant of Castleman's disease. Case report.
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.
Tsukamoto
Norifumi
N
Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Japan. ntukamot@med.gunma-u.ac.jp
Kojima
Masaru
M
Uchiyama
Toshimasa
T
Takeuchi
Tokio
T
Karasawa
Masamitsu
M
Murakami
Hirokazu
H
Sato
Sadao
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015139:Blotting, Southern; D018956:CD5 Antigens / Q000378:metabolism*; D005871:Castleman Disease / Q000378:metabolism / Q000473:pathology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D010950:Plasma Cells / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D014750:Vincristine / Q000627:therapeutic use
D018956:CD5 Antigens; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone