Facial Presentation of Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type: A Rare Case

TL;DR

An elderly woman with a rare facial lymphoma achieved long-term remission after treatment, highlighting the importance of considering this diagnosis in unusual skin lesions.

Contribution

This case report presents a rare facial presentation of primary cutaneous diffuse large B-cell lymphoma, leg type.

Findings

The patient was diagnosed with PCDLBCL-LT after a skin biopsy and immunohistochemical analysis.

Treatment with R-CHOP chemotherapy and radiation led to complete remission.

No recurrence was observed nearly 10 years after treatment.

Abstract

An elderly woman presented with a solitary ulcerated facial lesion, which raised concern for various diagnoses, including squamous cell carcinoma, melanoma, basal cell carcinoma, or an infection. Given the lesion's unusual location, a skin biopsy was performed, and immunohistochemical analysis confirmed the diagnosis of primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). PCDLBCL-LT is a rare, aggressive form of lymphoma that typically manifests on the legs but can, as in this case, present in atypical sites such as the face. She was treated with a combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy and radiation therapy, leading to a complete remission. Remarkably, after nearly 10 years, there has been no recurrence of the disease. This case highlights the importance of considering cutaneous lymphoma in the differential diagnosis for isolated, ulcerated skin lesions, even when they appear in uncommon locations, and emphasizes the potential for successful outcomes with early and appropriate treatment.

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