title: Primary cutaneous spindle cell B-cell lymphoma of follicle origin mimicking acne rosacea.
abstract: Primary cutaneous spindle cell lymphoma is a unique morphologic variant of cutaneous B-cell follicle center lymphoma characterized by a prominent population of spindle-shaped, medium, and large B lymphocytes with a poorly formed storiform pattern.We report a case of a 35-year-old woman who presented with a well-defined erythematous plaque with 2 nodular, nontender nonscaling nonulcerated lesions on her right cheek mimicking acne rosacea. Microscopic examination revealed a tumor mainly centered in the reticular dermis and mostly composed of spindle-shaped large B lymphocytes exhibiting bizarre shapes with "boomerang-like" or "spermatozoa-like" appearance. The immunohistochemical staining demonstrated neoplastic lymphocytes positive for CD20, CD79α, and BCL-6, and negative for CD3, CD43, CD10, BCL-2, and MUM-1. These results supported the diagnosis of a follicle center B-cell lymphoma with spindle cells.Although this rare variant of primary cutaneous B-cell lymphoma is not included in the recent WHO-EORTC classification, the rarity of this tumor and its unique morphologic appearance frequently leads to misdiagnosis and delays its treatment.
authors.affiliation: *Department of Pathology, Instituto de Investigación i+12 Hospital Universitario 12 de Octubre, Complutense University, Madrid, Spain; †Department of Pathology, Hospital Universitario Virgen Macarena, Seville, Spain; and Departments of ‡Pathology, and §Dermatology, Hospital Infanta Elena, Huelva, Spain.
authors.forename: María C
authors.initials: MC
authors.lastname: Garrido
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Rios
authors.forename: Erica
authors.initials: E
authors.lastname: Riveiro-Falkenbach
authors.forename: Pilar J
authors.initials: PJ
authors.lastname: Escamez
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ronco
authors.forename: Jose L
authors.initials: JL
authors.lastname: Rodríguez-Peralto
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016393:Lymphoma, B-Cell / Q000473:pathology*; D012393:Rosacea / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor