Al-Obaidi Ammar, Parker Nathaniel A, Choucair Khalil, Lalich Daniel, Truong Phu
Internal Medicine, University of Kansas School of Medicine, Wichita, USA.
Pathology, Wesley Medical Center, Wichita, USA.
Cureus. 2020 Jun 16;12(6):e8651. doi: 10.7759/cureus.8651.
Primary cutaneous diffuse large B-cell lymphoma, leg type, is an exceedingly rare and aggressive variant of primary cutaneous lymphoma. An 84-year-old male presented to an oncologist for new skin lesions on his abdomen and right thigh. Excisional biopsy followed by histopathology and immunohistochemistry confirmed the diagnosis of primary cutaneous diffuse large B-cell lymphoma, leg type. His clinical course was complicated by multiple relapses and refractory disease. Ultimately, he achieved complete response with fourth-line ibrutinib therapy. Due to the contentious nature of this disease, poor prognosis, and higher rates of recurrence, prompt identification and aggressive treatment are recommended. Given the different cellular pathways and genomic alterations identified in its carcinogenesis, various chemotherapy regimens and targeted immunotherapies have emerged as potential therapeutic options to halt disease progression and prevent future relapses.
原发性皮肤弥漫性大B细胞淋巴瘤,腿部型,是原发性皮肤淋巴瘤中极其罕见且侵袭性强的一种变体。一名84岁男性因腹部和右大腿出现新的皮肤病变而就诊于肿瘤学家。切除活检后经组织病理学和免疫组织化学检查确诊为原发性皮肤弥漫性大B细胞淋巴瘤,腿部型。他的临床病程因多次复发和难治性疾病而复杂化。最终,他接受四线伊布替尼治疗后实现了完全缓解。鉴于这种疾病的争议性、预后不良以及较高的复发率,建议尽早识别并积极治疗。鉴于其致癌过程中发现的不同细胞途径和基因组改变,各种化疗方案和靶向免疫疗法已成为阻止疾病进展和预防未来复发的潜在治疗选择。