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Indian Journal of Dermatology, Venereology and Leprology
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
ISSN: 0378-6323
EISSN: 0973-3922
Vol. 77, No. 3, 2011, pp. 314-317
Bioline Code: dv11091
Full paper language: English
Document type: Case Report
Document available free of charge

Indian Journal of Dermatology, Venereology and Leprology, Vol. 77, No. 3, 2011, pp. 314-317

 en Primary cutaneous follicle center lymphoma in the setting of chronic lymphocytic leukemia
Konda, S.; Beckford, A.; Demierre, M.F. & Mahalingam, M.

Abstract

Primary cutaneous malignancies arising in association with chronic lymphocytic leukemia (CLL) are notable for their atypical clinical and histological presentation. We report a 69-year-old man with a 17-year history of CLL who presented for evaluation of a well-defined red to violaceous nodule with a central depressed scar on the left lower extremity. Microscopic examination of a punch biopsy revealed an infiltrate of predominantly small lymphocytes with scattered large, atypical epithelioid cells. Immunohistochemical stains revealed diffuse positive staining of the lesional cells with CD20+ and bcl-6+ and focal positive staining with bcl-2+ (negative CD10 and CD23), findings which, in conjunction with the histology, were most compatible with a diagnosis of primary cutaneous follicle center lymphoma (PCFCL). A review of the clinical charts revealed several prior biopsies with varied diagnoses. In light of the most recent biopsy findings, all previous biopsies were re-reviewed and interpreted as PCFCL arising in the setting of CLL. Features contributing to the diagnostic conundrum in this case included an atypical clinical and histological presentation, lack of pertinent clinical history and multiple presentations at different institutions.

Keywords
Chronic lymphocytic leukemia, immunohistochemistry, primary cutaneous follicle center lymphoma

 
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Alternative site location: http://www.ijdvl.com

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