Primary cutaneous B-cell lymphoma in a child

Enigmatic Presentation of Primary Cutaneous Lymphoma in a Boy

Background

Primary cutaneous follicle center lymphoma (PCFCL) is a subtype of primary cutaneous B-cell lymphoma. It is exceedingly rare in the pediatric population, with less than two dozen cases documented in individuals younger than 20 years. The rarity of the disease, coupled with the scarcity of comprehensive clinical data, emphasizes the importance of a meticulous approach in the diagnostic process to avoid under-diagnosis or misdiagnosis.

Methods

We report a case of an eight-year-old boy who presented with a unique form of scalp lesion, ultimately diagnosed as PCFCL. A complete excision of the remaining defect was addressed by a rotational flap based on the superficial temporal artery.

Results

Adopting a multidisciplinary approach in managing PCFCL in the pediatric age group exemplifies the importance of collaborative care in addressing complex and rare conditions. The favorable outcome post surgical intervention reinforces the role of complete excision in treating localized PCFCL, aligning with current treatment guidelines for this patient demographic.

Conclusions

The management of pediatric PCFCL consists of complete surgical excision as the primary treatment modality, reserving radiotherapy for cases of relapse. This case adds to the scant literature on pediatric primary cutaneous B-cell lymphoma and highlights this rare entity's diagnostic challenges and clinical peculiarities. Ongoing research is essential to enhance our understanding, refine diagnostic criteria, and develop more effective treatment protocols for PCFCL.

An adolescent with primary cutaneous follicle center lymphoma: a case report and literature review

Primary cutaneous follicle center lymphoma (PCFCL) differs from follicular lymphoma in biological behavior and molecular profile and is treated as a distinct entity, according to the 5th edition of the World Health Organization classification of hematolymphoid tumors. It is an uncommon cutaneous B-cell lymphoma that is considerably rare in children and adolescents. To date, only 13 cases of individuals younger than 20 years of age have been reported in the literature. The lack of relevant clinical epidemiological data in this population has hampered the investigation of its clinical and diagnostic aspects. Here we report the case of a 17-year-old male with PCFCL, who may be the first PCFCL patient under 20 years of age reported in China. He was admitted to the hospital with a solitary nodule on his face. After complete surgical excision, the patient's facial mass was histologically identified as PCFCL. The patient's prognosis was favorable, with no recurrence at 17 months of follow-up after the surgical resection. We present a case of an adolescent PCFCL patient and systematically review the literature with a view to increase the awareness of the disease and inform the diagnosis and treatment of this age group.

Primary Cutaneous Follicle Center Lymphoma Presenting as a Solitary Nodule on the Forearm of an Adolescent Girl: A Case Report and Literature Review

Primary cutaneous B-cell lymphomas (PCBCLs) are very rare to be seen in pediatric and adolescent age group, especially primary cutaneous follicle center lymphoma (PCFCL) which is considered the least occurring main subtype. Here, we describe a 16-year-old girl who developed a slowly growing solitary firm smooth surfaced erythematous nodule over her forearm. Histopathological examination showed a dense dermal nodular, periadnexal and perivascular lymphoid infiltrate extending deep to the subcutis. Immunohistochemical staining showed a B-cell population with positivity for CD20, variable staining for BCL6 and CD10 and uniquely staining for BCL2. Although a primary cutaneous marginal zone lymphoma (PCMZL) was considered but the presences of interfollicular BCL6 and CD10 positivity established the diagnosis of PCFCL. To our knowledge, only 12 cases of pediatric and adolescent PCFCL have been described in the literature.

Primary cutaneous follicle center lymphoma in a 16-year-old girl

In the pediatric and adolescent age group, primary cutaneous lymphomas are rare, especially cutaneous B-cell lymphomas. According to the World Health Organization, the three main subtypes of primary cutaneous B-cell lymphomas are primary cutaneous marginal zone B-cell lymphoma (PCMZL), primary cutaneous follicle center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type. We present an extraordinary case of PCFCL arising in a 16-year-old female, only the sixth case of PCFCL to be reported in the literature in a patient less than 20 years old. Although PCMZL was considered in this case, the finding of lambda light chain restriction in the BCL-6 and CD10 positive population of lymphocytes established the diagnosis of primary cutaneous follicle center lymphoma. Not many data currently exist on the prognosis of PCFCL in young individuals, but adult PCFCL has a good prognosis with an indolent course and 5-year survival rates over 95%. Because of its uncommon manifestation in young patients, the diagnosis of PCFCL is often delayed or missed. This case is presented to raise awareness of PCFCL in the pediatric/ adolescent population and to contribute to the ongoing research of this condition.

Cutaneous Hematolymphoid and Histiocytic Proliferations in Children

This article focuses on cutaneous hematopoietic neoplasms that are more likely to be encountered in the pediatric age-group and includes both lymphoproliferative and histiocytic disorders. The cutaneous hematologic disorders in children have a different epidemiologic profile to what is seen during adulthood. Although mycosis fungoides is the most frequent form of cutaneous lymphoma in adults, it is very rare in children. Because lymphoblastic leukemias and lymphomas are more frequent in the pediatric setting, cutaneous leukemic infiltrates are relatively common in this age-group. Similarly, histiocytic disorders are more common in children, particularly Langerhans cell histiocytosis and juvenile xanthogranuloma. Notably, the histiocytic disorders have undergone significant modifications on their nomenclature in the basis of the molecular characteristics that are present in them. A summary of the most frequent cutaneous hematopoietic disorders in children will be discussed further in this review.

A 92-year-old man with primary cutaneous diffuse large B-cell non-Hodgkin's lymphoma manifesting as a giant scalp mass: A case report

RATIONALE

Primary cutaneous non-Hodgkin's lymphoma (NHL) is an uncommon entity, representing 10% of all extranodal NHLs. Among all cutaneous sites, the scalp is a rare site of representation.

PATIENT CONCERNS

A 92-year-old Chinese man visited our hospital with a multiple-nodular huge scalp mass on the right parieto-occipital regions. The mass was of 7-month duration and progressively enlarging in size.

DIAGNOSES

On the basis of the result of biopsy, diffuse large B-cell NHL was diagnosed.

INTERVENTIONS

The mass was partially resected by surgery and no further treatment was conducted due to the advanced age and poor physical status.

OUTCOMES

The tumor relapsed in situ after 6 months and the patient died after 2 years.

LESSONS

This case highlighted the limited access to standard treatment options in patients with advanced age. A thorough examination is necessary to decide upon the treatment for the primary cutaneous lymphoma.

Primary Cutaneous Lymphomas in Children and Adolescents

Primary cutaneous lymphomas are rare in children and mostly represented by mycosis fungoides and CD30(+) lymphoproliferative disorders. Most pediatric cutaneous lymphomas have similar clinical/pathological features as their adult counterparts, particularly the T-cell subtypes. With regard to outcome, adult cutaneous mature T-cell lymphomas have a tendency to progression, while this appears to be relatively infrequent in children. The outcome of cutaneous B-cell lymphomas depends on subtype, with the B-lymphoblastic entity being associated with similar outcomes to precursor B acute lymphoblastic leukemia, while there are insufficient data on other entities. The diagnosis and treatment of these patients require a close collaboration between experienced pediatric pathologists, dermatologists, and oncologists. Prospective collection of longitudinal clinical and biological data from children with these rare lymphomas is needed to better understand their biological and clinical behavior and to ultimately discover the best therapeutic strategies.