Khatib Yasmeen, Dande Madhura, Patel Richa D, Makhija Meena
Department of Pathology, R. N. Cooper Hospital, Mumbai, Maharashtra, India.
Department of Dermatology, R. N. Cooper Hospital, Mumbai, Maharashtra, India.
Indian J Pathol Microbiol. 2017 Apr-Jun;60(2):268-271. doi: 10.4103/0377-4929.208414.
Primary cutaneous large B-cell lymphoma (Bcl) is defined as a lymphoma composed of large cells constituting more than 80% of the infiltrate and absence of extracutaneous involvement after staging investigations. In the new World Health Organization/European Organization for Research and Treatment of Cancer classification, cutaneous Bcls with large cells are of three types - primary cutaneous large Bcl leg type (PCLBCLLT), primary cutaneous follicle center lymphoma diffuse type (PCFCLDT), and primary cutaneous large Bcls other (PCLBCLO). These three different types are distinct in terms of their clinicopathological features and survival. The PCLBCLO has intermediate features between those of PCLBCLLT and PCFCLDT. We present a case of PCLBCLO in a 57-year-old male who presented with a scalp swelling. Ultrasonography examination was suggestive of a sebaceous cyst. Computed tomography scan revealed the presence of an ill-defined hyperdense region in the soft tissue of the scalp region extending into the deeper layers of the scalp. Fine-needle aspiration cytology (FNAC) revealed the presence of atypical lymphoid cells. Diagnosis was confirmed by biopsy and immunohistochemistry. Patient received rituximab combined with doxorubicin, vincristine, cyclophosphamide, and prednisolone regimen with complete resolution of the lesion. We present this case for its rarity, the utility of FNAC in early diagnosis, and to discuss the differential diagnosis.
原发性皮肤大B细胞淋巴瘤（Bcl）被定义为一种淋巴瘤，其由构成浸润细胞80%以上的大细胞组成，且在分期检查后无皮肤外受累。在世界卫生组织/欧洲癌症研究与治疗组织的新分类中，伴有大细胞的皮肤Bcl分为三种类型——原发性皮肤大Bcl腿部型（PCLBCLLT）、原发性皮肤滤泡中心淋巴瘤弥漫型（PCFCLDT）和原发性皮肤大Bcl其他型（PCLBCLO）。这三种不同类型在临床病理特征和生存率方面有所不同。PCLBCLO具有介于PCLBCLLT和PCFCLDT之间的中间特征。我们报告一例57岁男性的PCLBCLO病例，该患者表现为头皮肿胀。超声检查提示为皮脂腺囊肿。计算机断层扫描显示头皮区域软组织内存在边界不清的高密度区域，延伸至头皮深层。细针穿刺细胞学检查（FNAC）发现存在非典型淋巴细胞。活检和免疫组织化学确诊。患者接受利妥昔单抗联合多柔比星、长春新碱、环磷酰胺和泼尼松龙方案治疗，病变完全消退。我们展示此病例是因其罕见性、FNAC在早期诊断中的作用以及讨论鉴别诊断。
