title: Cutaneous diffuse large B-cell lymphoma of the leg associated with chronic lymphedema.
abstract: Development of malignant tumors is a rare but well known complication in chronic lymphedema (CL). We report herein a cutaneous diffuse large B-cell lymphoma of the leg associated with CL. An 89-year-old man presented with multiple cutaneous lesions on his right limb that showed a CL. Dermatological examination disclosed multiple violaceous, firm, slightly infiltrated nodules on the anterior aspect of the leg and the dorsum and sole of the foot. A biopsy of one nodule of the leg disclosed a diffuse large B-cell lymphoma, type of the legs. There was no evidence of lymphadenopathy on computed tomography (CT) scans of the chest, abdomen, and pelvis. A bone marrow aspiration and biopsy showed normal results. The patient was treated with local radiotherapy at a dose of 40 Gy, obtaining a highly significant, almost complete, clinical remission. A literature search identified 11 additional cases of primary cutaneous lymphoma associated with CL. An inadequate lymphatic drainage may make the lymphedematous region an immunologically vulnerable area, predisposing to neoplasia.
authors.affiliation: Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: González-Vela
authors.forename: Marcos A
authors.initials: MA
authors.lastname: González-López
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Val-Bernal
authors.forename: Héctor
authors.initials: H
authors.lastname: Fernández-Llaca
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000209:etiology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000532:radiotherapy; D008297:Male; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy