Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
Case Report
2003:69:7;22-23

Primary cutaneous b-cell lymphoma

PI Bhat, C Janaki, G Sentamilselvi, VR Janaki
 Department of Dermatology, Madras Medical College and Research Institute, Chennai-3, India

Correspondence Address:
V R Janaki
I-D, Lakshmi Apartments, 122, Fourth Street, Abhiramapuram, Chennai-600 018
India
How to cite this article:
Bhat P I, Janaki C, Sentamilselvi G, Janaki V R. Primary cutaneous b-cell lymphoma. Indian J Dermatol Venereol Leprol 2003;69:22-23
Copyright: (C)2003 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

A 54-year-old man, presented with leonine facies and multiple tumours more over the exposed parts of the body. On investigation, it turned out to be a case of primary cultaneous B-cell lymphoma with a distrinctive histopathology. Chemotherapy was given with a good therapeutic response.
Keywords: Primary cultaneous B cell lymphoma, Grenz zone

Introduction

Cutaneous lymphomas, arising from T or B lymphocytes, constitute an uncommon but nevertheless important entity with the so called Skin Associated Lymphoid Tissue (SALT) being either the origin (primary) or the target (secondary) in the neoplastic process.[1] The primary cutaneous lymphomas, by definition, present clinically on the skin with no extracutaneous disease at the time of diagnosis or for 6 months thereafter.2 Of these, primary cutaneous lymphomas of B cell origin are less common, their incidence being one third that of their T-cell counterpart.[3] Although several classifications like Kiel, Lukes and Collins, Rappaport and Revised European and American Lymphoma (REAL)[4] classification have been used, the one proposed by the European Organisation for Research and Treatment of Cancer (EORTC)[3] is the latest and being followed widely. The follicular centre cell type described in the EORTC classification is the commonest type of primary cutaneous B cell lymphoma and shows a characteristic histopathology5 and expression of cell surface markers like CD 19, CD 20, CD 79a[1],[6] one such case is described below.

Case Report

A 54-year-old man who been a road layer for 30 years presented with one year history of progressively enlarging swellings over the face, chest and forearms. Lesions were mildly photosensitive.

On examination, multiple tumour masses of firm consistency were found infiltrating the forehead and malar areas to produce a leonine appearance [Figure - 1]. Overlying skin was hyperpigmented with peu-de-orange appearance. Similar lesions were found on the neck, upper back and dorsal aspect of forearms. No significant lymphadenopathy was detected clinically.

Histopathology of involved skin showed a normal epidermis with absence of epidermotropism. A clear subepidermal cell free Grenz zone was seen in the papillary dermis. The mid and lower dermis were diffusely infiltrated by small, round lymphocytes in a bottom heavy pattern [Figure - 2]. Radiological and bone marrow aspiration studies revealed no extracutaneous pathology.

Immuno histochemical techniques for cell markers was done. A final diagnosis of primary cutaneous B cell lymphoma of follicular centre cell type was made.

Chemotherapy with use of cyclophosphamide, adriamycin, oncovin and prednisolone was started. An excellent response with near total resolution of lesions was seen [Figure - 3]. Patient is being followed up at regular intervals.

Discussion

The follicular centre cell type of primary cutaneous B cell lymphoma with its classical histopathology[5] and cell markers, as seen in this case has a favourable prognosis with good therapeutic response, a fact well documented in literature.[2],[7] Interestingly, with the patient′s history of life long exposure to coal tar and sunlight, and with the distribution of lesions being limited to the exposed areas of the body, the possibility of these environmental factors playing a carcinogenic role in primary cutaneous B cell lymphoma, although hitherto unreported, needs be further explored.

References
1.
Giannotti B, Santucci M. Skin associated lymphoid tissue (SALT) related B cell lyphoma (primary cutaneous B cell lymphoma) : A concept and clinicopathological entity. Arch Dermatol 1993; 129:353-355.
[Google Scholar]
2.
Sterry W, John S. Other systemic lymphomas with skin infiltrates. In: Freeedberg IM, Fitzpatrick TB, et al, edrs. Dermatology in General Medicine. 5th edn. New York: Mc Graw Hill, 1999 : 1250-1258.
[Google Scholar]
3.
Willemze R, Kerl H, Sterry W, et al. EORTC classification of primary cutaneous lymphomas : A proposal from the cutaneous lymphoma study group of the European Organization for Research and Treatment of Cancer. Blood 1997; 90:354-371.
[Google Scholar]
4.
Harris NL, Jaffe ES et al. A revised European - American Classification of lymphoid neoplasms : A proposal from the International Lymphoma Study Group. Blood 1994; 84:1361.
[Google Scholar]
5.
Mackie RM. Cutaneous lymphomas and lymphocytic infiltrates. In : Champion RH, Burton JL, et al, edrs. Textbook of Dermatology. 6th edn. London : Blackwell Science Ltd, 1998 : 2393-2395.
[Google Scholar]
6.
Willemze R. Sentis HJ, Et al. Primary cutaneous large cell lymphoma of follicular centre cell origin. J Am Acad Dermatol 1987; 16L518-526.
[Google Scholar]
7.
Rijlaarsdam JV et al. : Treatment of Primary cutaneous B Cell Lymphoma of follicular centre cell origin - A clinical follow-up of 55 patients treated with radiotherapy of polychemotherapy. Journal of Clinical Oncology 1996; 14:549.
[Google Scholar]
Show Sections