Cutaneous diffuse large B-cell lymphomas, primary and secondary

Cases were selected in which more than 75% of the cutaneous lymphoma consisted of large transformed B-cells. They were classified as primary if there was no antecedent or contemporaneous extracutaneous lymphoma and none developed within six months of diagnosis1. These cases predominantly involved the head, neck or trunk.

Immunohistochemistry

 

primary cutaneous

secondary cutaneous

cutaneous, NOS

comparison with classic FL

 

  

CD10

2/111, 1/152

5/81

3/61

60-90%

CD138

0/111

1/81

1/61

 

bcl-2

6/111, 10/152, 21/253

8/81

4/61

 85%

bcl-6

11/111, 8/152, 18/253

8/81

5/61

almost 100%

t(14;18)

0/91, 0/152

3/51

0/31

 
 

These results confirm the lack of t(14;18), as in the generality of cutaneous follicular B-cell lymphomas. They also differ from nodal follicular lymphomas in the lack of CD10 reactivity in most cases.

Cytogenetics

Other than the lack of t(14;18), the structural and numeric chromosomal abnormalities are variable and comparable to those seen in nodal DLBCL3.

Differential diagnosis

Prognosis

Among non-leg cases, recurrences are common, but death of disease is rare: those cases occurring on the thigh or leg appear to be more aggressive2.

References

1 Kim, B.K., Surti, U., Pandya, A.G. and Swerdlow, S.H. Primary and Secondary Cutaneous Diffuse Large B-Cell Lymphomas: A Multiparameter Analysis of 25 Cases Including Fluorescence In Situ Hybridization for t(14;18) Translocation. Am J Surg Pathol 2003;27:356-64.

2 Hembury, T.A., Lee, B., Gascoyne, R.D., Macpherson, N., Yang, B., House, N., Medeiros, L.J. and Hsi, E.D. Primary cutaneous diffuse large B-cell lymphoma: a clinicopathologic study of 15 cases. Am J Clin Pathol 2002;117:574-80.

3 Wiesner T, Streubel B, Huber D, et al. Genetic aberrations in primary cutaneous large B-cell lymphoma: a fluorescence in situ hybridization study of 25 cases. Am J Surg Pathol 2005; 29:666-73

This page last revised 19.7.2005.

©SMUHT/PW Bishop