title: Unusual clinicopathological presentation of primary cutaneous diffuse large B-cell lymphoma, leg type, with multiple nodules and widespread garland-like lesions.
abstract: We present a case of primary cutaneous diffuse large B-cell lymphoma, leg type, with an unusual clinical picture. A 41-year-old man presented with a 2-year history of slowly progressive plaques, nodules, and garland-like patches on his chest, right upper arm, and back. Complete staging investigations revealed no extracutaneous involvement. Histological examination of a nodule revealed a diffuse nonepidermotropic infiltrate mainly composed of large blast cells with features of immunoblasts and centroblasts and spindle cells seen at the periphery of the infiltrate. Histological examination of a garland-like lesion showed perivascular infiltrates composed predominantly of small lymphocytes admixed with only occasional large blasts. The blasts from the nodule and garland-like lesions and spindle cells identified in the nodule exhibited an identical phenotype: they stained positively for CD20, CD79a, and bcl-2 and tested negative for bcl-6, CD5, CD10, and TdT. CD35 revealed no networks of follicular dendritic cells. Widespread garland-like lesions are not a typical feature of primary cutaneous diffuse large B-cell lymphoma.
authors.affiliation: Department of Dermatology and Venereology, Medical Military Academy, Saint-Petersburg, Russia.
authors.forename: Irena E
authors.initials: IE
authors.lastname: Belousova
authors.forename: Tomas
authors.initials: T
authors.lastname: Vanecek
authors.forename: Sergey V
authors.initials: SV
authors.lastname: Skreg
authors.forename: Anatoly N
authors.initials: AN
authors.lastname: Rodionov
authors.forename: Alexey V
authors.initials: AV
authors.lastname: Samtsov
authors.forename: Dmitry V
authors.initials: DV
authors.lastname: Kazakov
mesh_terms: D000328:Adult; D001483:Base Sequence; D001706:Biopsy; D015321:Gene Rearrangement; D050438:Genes, Immunoglobulin Heavy Chain / Q000235:genetics; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000235:genetics* / Q000473:pathology*; D008297:Male; D010641:Phenotype; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000145:classification / Q000235:genetics* / Q000473:pathology*