A Unique Presentation of Cutaneous Diffuse Large B-Cell Lymphoma

Abstract

Cutaneous B-cell lymphomas (CBCL) are rare heterogeneous neoplastic diseases composing about 22.5% of all cutaneous lymphomas. These diseases can be divided into primary and secondary cutaneous variants with primary cutaneous B-cell lymphoma (PCBCL) divided into three distinct entities including primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT). Secondary cutaneous diffuse large B-cell lymphoma (CDLBCL) and PCDLBCL, LT are more aggressive neoplasms compared to the aforementioned CBCL with survival rates of 37% and 50% after 5 years, respectively. CDLBCL can present as cutaneous or subcutaneous nodules, papular lesions, or indurated plaques. Here, we present a case of CDLBCL of an 88-year-old female that was mistaken for lower extremity cellulitis with phlegmon. Our patient failed two courses of antibiotic therapy as an outpatient and received a third as an inpatient before a cutaneous biopsy clinched the diagnosis.

A rare case of primary cutaneous diffuse large B-cell lymphoma, leg type, presenting as cellulitis: a case report

“…Primary cutaneous B-cell lymphomas primarily involve the skin; however, the appearance of the skin lesion may vary from obvious masses, plaques or nodules to only redness and mild swelling that can mimic skin or soft tissue infection such as cellulitis and mislead less-experienced clinicians. Mistaking cutaneous diffuse large B-cell lymphomas for skin cellulitis may result in not only unnecessary interventions, such as needle aspiration or incision and drainage, but also a delay to proper antineoplastic treatment [ 5 ]. In this case report, we provide detailed clinical history and photographs of the skin lesions found in this condition.…”