Spontaneous Regression Of Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type With Significant T-cell Immune Response
Graham, P. M., Richardson, A. S., Schapiro, B. L., Saunders, M. D., & Stewart, D. M. (2018). Spontaneous regression of primary cutaneous diffuse large B-cell lymphoma, leg type with significant T-cell immune response. JAAD case reports, 4(4), 305–309. https://doi.org/10.1016/j.jdcr.2017.10.012
View Original Source →Abstract
We report a case of histologically confirmed primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) that subsequently underwent spontaneous regression in the absence of systemic treatment. The case showed an atypical lymphoid infiltrate that was CD20+ and MUM-1+ and CD10-. A subsequent biopsy of the spontaneously regressed lesion showed fibrosis associated with a lymphocytic infiltrate comprising reactive T cells. PCDLBCL-LT is a cutaneous B-cell lymphoma with a poor prognosis, which is usually treated with chemotherapy. We describe a case of clinical and histologic spontaneous regression in a patient with PCDLBCL-LT who had a negative systemic workup but a recurrence over a year after his initial presentation.
Case Details
Disease Location
Skin
Personal Characteristics
79-year-old white man
Clinical Characteristics
Presented with a plaque on his left leg that was present for 1 week. Examination found a 20 x 12 cm irregular, rectangular-shaped, erythematous, reticulated plaque on his left anterior shin with prominent follicular accentuation. Biopsy found an atypical lymphoid infiltrate in the upper dermis compatible with a primary cutaneous diffuse large b-cell lymphoma, leg type (pcdlbcl-lt). More than a year after remission, the patient presented with a new plaque confirmed as a recurrence of his pcdlbcl-lt.
Remission Characteristics
Approximately 1 month later, the plaque spontaneously resolved, and a punch biopsy of the area found a superficial and deep perivascular inflammatory infiltrate comprised of mature lymphocytes.
Treatment & Mechanisms
Clinical Treatment
Biopsy
Non-Clinical Treatment
None reported