TY - JOUR AU - Wollina, Uwe AU - Schmidt, Nadine AU - Schönlebe, Jacqueline AU - Vojvodic, Aleksandra AU - Hansel, Gesina AU - Koch, André AU - Lotti, Torello PY - 2019/06/30 Y2 - 2024/03/28 TI - Large B - Cell Lymphoma of the Leg – Unfavourable Course with Rituximab/Bendamustin JF - Open Access Macedonian Journal of Medical Sciences JA - Open Access Maced J Med Sci VL - 7 IS - 18 SE - Dermatology DO - 10.3889/oamjms.2019.565 UR - https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.565 SP - 3006-3008 AB - <p><strong>BACKGROUND:</strong> Cutaneous B-cell lymphomas represent about 25% of all cutaneous lymphomas. Peripheral diffuse large B-cell lymphoma of the leg type is the most aggressive subtype seen mainly in elderly patients. Treatment is not standardised.</p><p><strong>CASE REPORT:</strong> An 87-year-old female patient was presented in May 2018 because of the development of painless subcutaneous nodules on the legs since late 2017.&nbsp;On examination, we observed up to 5 cm large erythematous nodules on the legs and a smaller plaque in the left submammary fold. The histology of a skin demonstrated tumour infiltrate that was separated from the overlying epidermis by a grenz zone. It consisted of densely packed, blastoid lymphocytic cells with numerous, and some atypical mitoses. The cells were positive for CD20, CD79A and CD5. Almost 100% of the cells were labelled with Ki67.&nbsp;The diagnosis of a diffuse large B-cell lymphoma (PCLBCL-LT) of the leg was confirmed.&nbsp;Histologic analysis of a bone marrow biopsy demonstrated a hypercellular bone marrow without malignant lymphatic infiltrates.&nbsp;Diagnostic ultrasound of cervical nodes and computerised tomography (CT) scans (native and with contrast medium) of head, neck and trunk excluded an extracutaneous manifestation of the PCLBCL-LT. Treatment with rituximab plus bendamustibe was initiated, but tumour progress was noted after the second course. Suggested palliative therapy with radiation and rituximab was refused. The patient died 7 months after diagnosis.</p><p><strong>CONCLUSIONS:</strong> Although some trials suggested a beneficial effect of immuno-chemotherapy, the prognosis of&nbsp;(PCLBCL-LT) remains poor. Standardised treatment is missing due to the relative rarity of this malignancy.</p> ER -