Abe Masaya, Ohno Kyotaro, Nakagawa Yuki, Sato Yasuharu, Sugiura Hiroyuki
Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
Department of Pathology, Fukuyama City Hospital, Fukuyama, Japan.
Case Rep Oncol. 2024 Sep 30;17(1):1094-1102. doi: 10.1159/000540913. eCollection 2024 Jan-Dec.
Erythema nodosum (EN) is the most common form of panniculitis. EN can be idiopathic or secondary to an underlying systemic disease, infection, drug use, or tumor. CD5-positive diffuse large B-cell lymphoma (CD5+ DLBCL) is a relapsed and refractory lymphoma, and further understanding of its pathology is required. We report a case of newly diagnosed CD5+ DLBCL with concomitant EN. Within the scope of our search, there were no reports of CD5+ DLBCL complicated with EN.
A 79-year-old woman experienced swelling, warmth, redness, and pain in both legs and a mass lesion on the right side of the back at almost the same time. The respective lesions were diagnosed as EN and CD5+ DLBCL by biopsy. With chemotherapy, the lymphoma and EN improved in parallel courses. The patient has completed scheduled chemotherapy, and there has been no recurrence of swelling in the legs or mass on the right side of the back.
The lymphoma and EN developed simultaneously and followed a parallel clinical course after chemotherapy, suggesting that EN was a paraneoplastic symptom of CD5+ DLBCL. Recognizing and treating underlying malignancies in patients presenting with EN is crucial.
结节性红斑（EN）是脂膜炎最常见的形式。EN可为特发性，或继发于潜在的全身性疾病、感染、药物使用或肿瘤。CD5阳性弥漫性大B细胞淋巴瘤（CD5+ DLBCL）是一种复发难治性淋巴瘤，需要进一步了解其病理学特征。我们报告一例新诊断的CD5+ DLBCL合并EN的病例。在我们检索的范围内，尚无CD5+ DLBCL合并EN的报道。
一名79岁女性几乎同时出现双下肢肿胀、发热、发红和疼痛，以及背部右侧的肿块病变。活检分别将各病变诊断为EN和CD5+ DLBCL。通过化疗，淋巴瘤和EN在平行病程中得到改善。患者已完成预定化疗，双下肢未再出现肿胀，背部右侧肿块也未复发。
淋巴瘤和EN同时发生，化疗后临床病程平行，提示EN是CD5+ DLBCL的副肿瘤症状。识别并治疗出现EN的患者的潜在恶性肿瘤至关重要。
