Small lymphocytic lymphoma mimicking primary cutaneous marginal zone lymphoma with colonization of germinal center follicles.
CLL/SLL
clinical correlation
immunohistochemistry
lymphoma
marginal zone
Journal
Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
06
05
2020
revised:
26
05
2020
accepted:
28
05
2020
pubmed:
9
6
2020
medline:
2
10
2021
entrez:
8
6
2020
Statut:
ppublish
Résumé
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is primarily a disease of older adults and is occasionally an incidental finding on skin biopsies accompanying epithelial neoplasms and insect bite reactions. In rare instances, however, it produces leukemic infiltrates showing clinical and histopathologic overlap with primary cutaneous B-cell lymphomas including primary cutaneous marginal zone lymphoma (PCMZL). Even less frequently, such findings serve as the initial disease manifestation. We present an exceptional case of a 61-year-old man with no past medical history whose clinical and histopathologic findings raised consideration for PCMZL with abnormal B-cells colonizing germinal center follicles; however, faint CD5 and CD23 co-expression raised the differential diagnosis of CLL/SLL. In light of an ambiguous clinical presentation with widely distributed papules and plaques, peripheral blood flow cytometry was also performed, revealing high count of CLL-type monoclonal B lymphocytosis. Subsequent workup revealed bone marrow involvement and mesenteric lymphadenopathy, supporting the diagnosis of SLL. Follicular colonization by SLL has not been previously reported. Our case underscores the importance of subtle immunophenotypic clues and correlations with clinical and radiologic findings in the workup of B-cell lymphomas presenting in the skin.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
72-76Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
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