Disseminated Cutaneous B-cell Lymphoma Mimicking Pseudolymphoma over a Period of Six Years

Abstract

We describe a patient with a disseminated nodular cutaneous B-cell lymphoma, whose diagnosis was finally made after a long series of biopsies in different institutions in Europe and the United States. The differential diagnosis between lymphoma and pseudolymphoma was the recurrent problem throughout the patient's history because histologic and immunophenotypic criteria alone were not sufficient for differentiation. Molecular biology inconsistently detected clonal immunoglobulin rearrangements, which proves that careful clinicopathologic correlation remains mandatory. In contrast to a claimed "high-grade" malignant histology, this lymphoma responded with remission to PUVA therapy combined with intralesional corticosteroids, which is uncommon in the management of cutaneous B-lymphomas.

Primary cutaneous marginal zone lymphoma with subclinical cutaneous involvement and biclonality

“…Complete responses have been reported with interferon‐α in a number of subtypes of primary cutaneous B‐cell lymphoma, including PCMZL 10–12 . Although PUVA has been used primarily for the treatment of cutaneous T‐cell lymphoma, remission of cutaneous B‐cell lymphoma with the use of PUVA has also been reported 13 . Both treatment modalities are potentially suitable for maintenance treatment, if needed, and both are generally well tolerated.…”

“…10 -12 Although PUVA has been used primarily for the treatment of cutaneous T-cell lymphoma, remission of cutaneous B-cell lymphoma with the use of PUVA has also been reported. 13 Both treatment modalities are potentially suitable for maintenance treatment, if needed, and both are generally well tolerated. Unfortunately, the patient moved away and was lost to follow-up.…”