Rare aggressive presentation of primary cutaneous diffuse large B-Cell lymphoma, leg type, in the upper arm with concurrent non-small cell lung cancer
Alatawi, Zinab Passby, Lauren Kaushal, Ghazia
Alatawi, Zinab
Passby, Lauren
Kaushal, Ghazia
Affiliation
University of Tabuk; University Hospitals Birmingham NHS Foundation Trust
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Publication date
2025-05-30
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Abstract
A female patient in her early 90s presented with a rapidly growing erythematous plaque on the right upper arm. Histopathological analysis revealed dense dermal lymphoid infiltrate with a non-germinal centre phenotype (CD20+, MUM1+, BCL2+, BCL6+, CD10-). Histology confirmed the diagnosis to be primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). Elevated Ki-67 (90%) indicated aggressive disease. Subsequent Positron Emission Tomography (PET)-CT staging revealed right axillary lymphadenopathy and coincidentally diagnosed recurrent non-small cell lung cancer (NSCLC). The PCDLBCL-LT was treated with localised radiotherapy after the patient declined chemotherapy. This case report highlights an unusual presentation of PCDLBCL-LT on the upper limb. It further emphasises the challenges posed in diagnosing and treating solitary skin lesions among older patients with a prior oncological history while highlighting the importance of an individualised multidisciplinary approach for safe and efficacious treatment in the context of advanced age and multiple comorbidities.
Citation
Alatawi Z, Passby L, Kaushal G. Rare aggressive presentation of primary cutaneous diffuse large B-Cell lymphoma, leg type, in the upper arm with concurrent non-small cell lung cancer. BMJ Case Rep. 2025 May 30;18(5):e264401. doi: 10.1136/bcr-2024-264401.
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