1 / 20

Case 6

Case 6. F, 75 ys Erythematous nodule of the lower left leg. CD20. Bcl-6. Bcl-2. CD10. CD3. Mib-1. DIAGNOSIS. Diffuse large B cell lymphoma Work-up : peripheral blood, bone marrow, CT scan: all negative. Follow-up (after 17 months). Local recurrence of the lesion New biopsy

reece
Download Presentation

Case 6

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Case 6 F, 75 ys Erythematous nodule of the lower left leg

  2. CD20

  3. Bcl-6

  4. Bcl-2

  5. CD10

  6. CD3

  7. Mib-1

  8. DIAGNOSIS • Diffuse large B cell lymphoma • Work-up: peripheral blood, bone marrow, CT scan: all negative

  9. Follow-up (after 17 months) • Local recurrence of the lesion • New biopsy • Same morphology • Subcutaneous tissue involvement • But...

  10. CD5

  11. Cyclin-D1

  12. FINAL DIAGNOSIS • Primary cutaneous MCL, blastoid variant, with aberrant bcl-6/CD10 expression Cesinaro AM, Bettelli S, Maccio L, Milani M. Primary Cutaneous Mantle Cell Lymphoma of the Leg With Blastoid Morphology and Aberrant Immunophenotype: A Diagnostic Challenge. Am J Dermatopathol. 2013 Apr 22. [Epub ahead of print].

  13. Cyclin-D1+ ↑ Mib-1 CD5 - FISH breakapart (t11;14)

  14. Work-up: peripheral blood, bone marrow and CT scan negative • Therapy: local radiotherapy • 14 months later: ulcer of the tongue: MCL • Further work-up: peripheral blood, bone marrow and CT scan negative • Therapy: 3 cycles of chemotherapy • Recurrence and pulmonary complications • Death 40 months after first skin biopsy

  15. PITFALLS in MCL diagnosis • Aberrant expression of B cell markers (CD10, bcl-6) • Sometimes negativity for CD5 • Blastoid morphology: DD with diffuse large B cell lymphoma • Involvement of the skin, usually secondary • Very rare cases of bona fide primary cutaneous MCL Note:diagnostic value of IIC and FISH

More Related