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Lymphoplasmocytoid Immunocytoma

Aelbrecht & Geerights, 1990Lymphoma

Aelbrecht, M., & Geerights, M. L. (1990). Lymphoplasmocytoid immunocytoma. Dermatologica, 180(3), 191–192.

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Abstract

A 68-year-old male patient presented with numerous red-brown papules on the trunk and neck. Cutaneous lymphoplasmocytoid immunocytoma was diagnosed following histological and electron microscopical detection of atypical lymphoid cells in the dermis. Immunohistochemistry revealed a monoclonal proliferation of IgG-kappa-positive B-lymphocytes. There was no extracutaneous manifestation of the lymphoma. Complete remission was affected by total-body irradiation with an electron beam.

Case Details

Disease Location

Face, neck, trunk

Personal Characteristics

75 -year-old female

Clinical Characteristics

First seen in january 1987 since december 1986 she had violet tumors in the face, neck, and on the trunk. They were firm and measured between 1 and 4 cm biopsy was taken on 2/12/1986 (im assuming this is dd/mm/yyyy format) and suggested the diagnosis of pseudolymphoma, however this did not fit with the clinical aspect and another biopsy was taken for ihc. Histology of a tumor showed a dense dermal infiltrate with small lymphocytes, immunoblasts and plasmocytoid cells. This suggested a b-cell lymphoma, viz. A lymphoplasmocytoid immunocytoma with a few immunoblastic cells. The cells were positive for CD22, leu14, HLA-dr, and okt 10. In the plasmocytoid cells, IGG immunoglobulins with the short chain kappa were found electronmicroscopic exam showed also lymphoplasmocytoid cells with marginal chromatin in the nucleus the endoplasmatic reticulum was located concentrically around this nucleus and formed sometimes big cisterns the patient refused further exam or therapy and was not seen again until august 1987 when she presented with high fever, probably due to an intestinal infection by clostridium difficile physical exam found biolet tumors on the face, chest and the back. Large cervical, supraclavicular, axillary and inguinal lymph nodes were palpable lab tests: blood sedimentation rate 20/58, rbc 2.93million, hemoglobin 9.3g/dl, ldh 638u/l, very high fractions 3 and 4, hypoalbuminemia 24.4g/l, high gammaglobulins 33.9%, IGG 9.6g/l, agar gel electrophoresis, band of IGG kappa. Biposy of ln: lymphoplasmocytoid immunocytoma echography of the abdomen found enlarged liver and spleen cat of the abdomen found 2 lesions in the spleen, possibly lymphoma some lymph nodes in the retroperitoneal area radionuclide scan of the liver and spleen found an enlarged spleen gallium scan of the lymph nodes found increased activity in the neck, left axilla, the groins, and abdomen

Remission Characteristics

With no treatment, spontaneous involution of the tumors occurred 10 months of follow-up shows no relapse

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

None reported

Non-Clinical Treatment

None reported