Lymphoma skin rash pictures
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Summary
5 papers analyzed
These studies suggest that lymphoma-related skin rashes can present as diffuse, non-pruritic purple rashes, debilitating rashes requiring specialist management, or rashes with pleomorphic large atypical cells, often involving genetic mutations.
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Lymphoma Skin Rash: Clinical Presentations and Diagnostic Insights
Diffuse Large B-Cell Lymphoma (DLBCL) Skin Rash
Clinical Presentation and Characteristics
Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive subtype of non-Hodgkin's lymphoma that can present with skin manifestations. A notable case involved a 66-year-old woman who exhibited a diffuse, non-pruritic, purple rash on her lower extremities. The rash included non-blanching, pink/purple papules and an indurated, firm plaque. This presentation underscores the importance of recognizing skin rashes as potential indicators of underlying hematologic malignancies.
Diagnostic Findings
In this case, laboratory studies revealed significant leukocytosis and elevated lactate dehydrogenase levels. Flow cytometry identified neoplastic B-lymphoid cells, and a punch biopsy confirmed dense infiltration of the subcutaneous fat and dermis by CD20, CD10, and MUM-1 positive B-lymphoid cells. These findings were consistent with leukemic-phase DLBCL, highlighting the need for comprehensive diagnostic evaluations in patients presenting with unusual skin rashes.
Cutaneous T-Cell Lymphoma (CTCL) Skin Rash
Clinical Presentation and Characteristics
Cutaneous T-cell lymphoma (CTCL) can present with a generalized pruritic skin eruption. A case involving a 66-year-old man demonstrated a pruritic rash along the face, thorax, and extremities, which worsened over several months before diagnosis. This case illustrates the insidious nature of CTCL and the challenges in diagnosing it based solely on clinical presentation.
Diagnostic Findings
Accurate diagnosis often requires invasive studies, such as skin biopsies, to identify characteristic dermatopathologic features. In this case, the patient was ultimately diagnosed with CTCL after presenting to the emergency department with worsening lesions. This emphasizes the importance of considering CTCL in patients with persistent, unexplained skin rashes.
Adult T-Cell Leukemia/Lymphoma (ATLL) Skin Rash
Clinical Presentation and Characteristics
Adult T-cell leukemia/lymphoma (ATLL) is associated with human T lymphotropic virus type 1 infection and can present with various skin manifestations. In a study of 110 patients, skin rashes included papular, erythroderma, nodulotumoral, plaques, and patches. These diverse presentations can complicate the diagnostic process.
Diagnostic Findings
Histopathologic findings in ATLL often include large pleomorphic cells, angiocentrism, and epidermal infiltration with Pautrier-like microabscesses. Immunophenotypic analysis typically shows CD4+/CD25+/CD7- cells, and next-generation sequencing can reveal multiple genetic mutations. These diagnostic markers are crucial for distinguishing ATLL from other lymphomas with similar skin presentations.
Mantle Cell Lymphoma (MCL) Skin Rash
Clinical Presentation and Characteristics
Mantle cell lymphoma (MCL) can also present with skin rashes, particularly during high-grade transformation. A 75-year-old male with relapsed MCL developed a rapidly progressive rash characterized by indurated erythema and maculopapular lesions. This case highlights the aggressive nature of transformed MCL and its potential to manifest with significant skin involvement.
Diagnostic Findings
Skin biopsy in this patient revealed a perivascular and periadnexal lymphoid infiltrate of atypical, pleomorphic cells. Immunohistochemistry confirmed the presence of CD20, CD79a, PAX5, and BCL2 positive cells, with a high Ki-67 proliferation index. These findings are indicative of high-grade transformation, necessitating prompt and aggressive treatment.
Extranodal Marginal Zone B-Cell Lymphoma Skin Rash
Clinical Presentation and Characteristics
Extranodal marginal zone B-cell lymphoma can mimic other dermatologic conditions, such as mycosis fungoides. A 57-year-old man presented with a pruritic rash on his chest, abdomen, and thighs, initially suggestive of mycosis fungoides. This case underscores the importance of considering lymphoma in the differential diagnosis of persistent skin rashes.
Diagnostic Findings
Histologic examination revealed a dense atypical dermal lymphoid infiltrate, and immunophenotyping identified CD20(+) B lymphocytes with aberrant CD43 expression. Clonal immunoglobulin gene rearrangement confirmed the diagnosis of extranodal marginal zone B-cell lymphoma. This case highlights the critical role of immunophenotyping in accurately diagnosing cutaneous lymphomas.
Conclusion
Skin rashes can be a significant clinical manifestation of various types of lymphomas, including DLBCL, CTCL, ATLL, MCL, and extranodal marginal zone B-cell lymphoma. Accurate diagnosis often requires a combination of clinical evaluation, laboratory studies, and histopathologic examination. Recognizing the diverse presentations of lymphoma-related skin rashes is essential for timely and effective management.
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