cutaneous B-cell lymphoma

Etiology

• may be primary (i.e. confined to the skin)
• may be associated with systemic B-cell lymphoma

Epidemiology

• age:> 50 years
• male:female ratio 27:1
• rare

Pathology

• dense nodular or diffuse monomorphous infiltrate of lymphocytes generally separated from the epidermis by a zone of normal collagen
• immunophenotyping: CD19, CD20, CD22, CD28
• immunoglobulin gene rearrangement

Clinical manifestations

• indurated plaques or nodules with a smooth surface
• generally single or multiple lesions, localized in distribution; if widespread, asymmetric distribution
• generally asymptomatic
• different shades of red to plum in color
• lesions firm, nontender, cutaneous of fixed subcutaneous masses
• lymphadenopathy with systemic B-cell lymphoma

Laboratory

• complete blood count (CBC)
• skin biopsy
• lymph node biopsy (if indicated)
• bone marrow biopsy

Differential diagnosis

• cutaneous T-cell lymphoma (mycosis fungoides)
• leukemia cutis
• leprosy
• granuloma faciale
• atypical mycobacterial infection
• sarcoidosis

Management

• radiation therapy for localized disease
• chemotherapy for systemic disease (see B-cell lymphoma)

More general terms

• cutaneous lymphoma
• B-cell lymphoid neoplasm (B-cell lymphoma)

Additional terms

• granuloma faciale; eosinophilic granuloma of skin
• leukemia cutis
• mycosis fungoides/Sezary syndrome
• sarcoidosis