Primary Cutaneous Spindle Cell B-Cell Lymphoma of Follicle Origin Mimicking Acne Rosacea. (June 2015)

• Record Type: Journal Article
• Authors: Garrido, María C.; Rios, Juan J.; Riveiro-Falkenbach, Erica; Escamez, Pilar J.; Ronco, Maria A.; Rodríguez-Peralto, Jose L.
• Is Part Of: American journal of dermatopathology. Volume 37:Number 6(2015)
• Publication Date: 2015-06
• Subjects: spindle cell lymphoma -- lymphoma of follicle center origin; Skin -- Diseases -- Periodicals; Histology, Pathological -- Periodicals; 616.50705
• DOI: 10.1097/DAD.0000000000000097
• Languages: English
• ISSNs: 0193-1091

Abstract

Abstract : Abstract: Primary cutaneous spindle cell lymphoma is a unique morphologic variant of cutaneous B-cell follicle center lymphoma characterized by a prominent population of spindle-shaped, medium, and large B lymphocytes with a poorly formed storiform pattern. We report a case of a 35-year-old woman who presented with a well-defined erythematous plaque with 2 nodular, nontender nonscaling nonulcerated lesions on her right cheek mimicking acne rosacea. Microscopic examination revealed a tumor mainly centered in the reticular dermis and mostly composed of spindle-shaped large B lymphocytes exhibiting bizarre shapes with "boomerang-like" or "spermatozoa-like" appearance. The immunohistochemical staining demonstrated neoplastic lymphocytes positive for CD20, CD79α, and BCL-6, and negative for CD3, CD43, CD10, BCL-2, and MUM-1. These results supported the diagnosis of a follicle center B-cell lymphoma with spindle cells. Although this rare variant of primary cutaneous B-cell lymphoma is not included in the recent WHO–EORTC classification, the rarity of this tumor and its unique morphologic appearance frequently leads to misdiagnosis and delays its treatment.