Primary diffuse large cell B-cell lymphoma of the soft tissue (leg)

Abstract

Primary lymphoma of soft tissue is very rare. A 59-year-old Japanese man presented left leg tumor measuring 3 × 3 × 2 cm without skin ulceration. A large incisional biopsy was performed. It showed atypical lymphoid cell proliferation in subcutaneous tissue next to the fascia. Immunohistochemically, the tumor cells were positive for CD45, CD20, CD79α, λ-chain, and p53 protein. The Ki-67 labeling was 100%. In contrast, they were negative for various types of cytokeratins, epithelial membrane antigen, CD3, CD30, CD10, CD45RO, TdT, κ-chain, CD56, bcl-2, bcl-6 and MUM1. A diagnosis of diffuse large B-cell lymphoma (DLBCL) of non-germinal center type (DLBCL-non-GC) of soft tissue was performed. Systemic investigation using various imaging modalities including CT, MRI and Ga-scintigraphy revealed lymph nodes swelling in the inguinal region. The patient was treated by R-CHOP chemotherapy and radiation. The tumor and lymph nodes were markedly reduced in size. He is now alive with disease two years after the first manifestation.

Keywords

• Lymphoma
• Soft tissue
• Histopathology