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Barzilai A, Amitay-Laish I, Didkovsky E, Feinmesser M, Dalal A, Schiby G, Hodak E. New Insights into Macular Type of Primary Cutaneous B-Cell Lymphoma: Extension of the Clinical and Histopathological Patterns. Dermatology 2022; 238:1018-1025. [PMID: 35817021 DOI: 10.1159/000525439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary cutaneous B-cell lymphoma (PCBCL) classically presents with papules, plaques, and nodules/tumors. Previous reports of PCBCL manifesting with macular lesions are scarce and focused on primary cutaneous follicle-center cell lymphoma (PCFCL). OBJECTIVES The objective of this study was to report our experience with PCBCL presenting with erythematous macules. METHODS Patients with low-grade PCBCL manifesting with erythematous patches, diagnosed and managed between January 2000 through December 2019 at 2 tertiary cutaneous-lymphoma outpatient clinics, were included. Clinical data were retrospectively collected, and biopsy specimens of the macules, and if present of the typical nodular/tumoral lesions, were reviewed. RESULTS There were 14 patients, aged 16-67 years, 8 had PCFCL and 6 marginal zone lymphoma (PCMZL). All had 1-15 cm erythematous macules, mimicking: interstitial granuloma annulare/vascular tumors/early-stage folliculotropic mycosis fungoides, or presenting with figurate erythema or livedo reticularis-like/net-like pattern. In 3 patients, macules were the presenting lesions, in 2 as the sole manifestation, whereas in 12 patients, typical PCBCL lesions were observed during disease course. The macules showed in all, superficial and deep perivascular infiltrates, and in most, periadnexal infiltrates. Micronodules were observed in 11 specimens, with nodular infiltrates also observed in 4. B cells comprised the majority of the lymphocytes in only 4. Seven of 11 cases tested showed immunoglobulin heavy chain monoclonality. CONCLUSIONS PCMZL and PCFCL may manifest with erythematous macules. Physicians should be aware of this unusual manifestation of low-grade PCBCL, which may represent a clinicopathological diagnostic pitfall.
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Affiliation(s)
- Aviv Barzilai
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel.,Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Amitay-Laish
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, .,Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel,
| | - Elena Didkovsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Meora Feinmesser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
| | - Adam Dalal
- Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel
| | - Ginette Schiby
- Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Emmilia Hodak
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel
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Dumont M, Battistella M, Ram-Wolff C, Bagot M, de Masson A. Diagnosis and Treatment of Primary Cutaneous B-Cell Lymphomas: State of the Art and Perspectives. Cancers (Basel) 2020; 12:cancers12061497. [PMID: 32521744 PMCID: PMC7352758 DOI: 10.3390/cancers12061497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022] Open
Abstract
Primary cutaneous B-cell lymphomas are rare entities that develop primarily in the skin. They constitute a heterogeneous group that represents around a quarter of primary cutaneous lymphomas. The 2018 update of the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification differentiates primary cutaneous marginal zone lymphoma and primary cutaneous follicle center lymphoma with an indolent course from primary cutaneous diffuse large B-cell lymphoma, leg type with an aggressive behavior. The broad spectrum of clinical presentations and the disease course marked by frequent relapses are diagnostic and therapeutic challenges. The classification of these diseases has been refined in recent years, which allows to better define their immunopathogenesis and specific management. In the present article, we review the main clinico-biological characteristics and the current therapeutic options of these three main subsets. Based on the recent therapeutic advances in nodal B-cell lymphomas, we focus on the development of novel treatment options applicable to primary cutaneous B-cell lymphomas, including targeted therapies, combination treatments and immunotherapeutic approaches, and cover basic, translational and clinical aspects aiming to improve the treatment of cutaneous B-cell lymphomas.
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Affiliation(s)
- Maëlle Dumont
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
| | - Maxime Battistella
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Pathology, APHP, Saint-Louis Hospital, F-75010 Paris, France
| | - Caroline Ram-Wolff
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
| | - Martine Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Correspondence: ; Tel.: +33-1-53-72-20-93; Fax: +33-1-42-49-40-38
| | - Adèle de Masson
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
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Ahmed AA, Almohanna H, Griggs J, Tosti A. Unusual Clinical Presentation of a Primary Cutaneous Follicle Center Lymphoma on the Scalp of a Middle-Aged Female: Case Report and Review of the Literature. Skin Appendage Disord 2019; 5:379-385. [PMID: 31799268 DOI: 10.1159/000501174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/27/2019] [Indexed: 01/07/2023] Open
Abstract
Primary cutaneous follicle center lymphoma (PCFCL) is a rare type of indolent, low-grade cutaneous B-cell lymphoma with an excellent prognosis. It usually presents with erythematous nodules and plaques on the head, neck, or back. The diagnosis is primarily based on histopathology, immunohistochemistry, and molecular studies. We describe a case of PCFCL causing a well-defined alopecic atrophic patch. The patch developed in the area of a large subcutaneous nodule that regressed after treatment with rituximab infusion. We hypothesize that the alopecia could have been caused by pressure.
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Affiliation(s)
- Azhar A Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hind Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jacob Griggs
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital, University of Miami Miller School of Medicine, Miami, Florida, USA
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