Linfoma cutáneo de la zona marginal
Primary cutaneous marginal zone B-cell lymphoma is an indolent lymphoid neoplasm originating in post-germinal B lymphocytes of the extranodal mucosa-associated lymphoid tissue (MALT) of the skin. Its frequency is 7% to 9% of all primary cutaneous lymphomas. It is associated with chronic inflammatory...
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| Autores principales: | , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2025
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/50432 |
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| Sumario: | Primary cutaneous marginal zone B-cell lymphoma is an indolent lymphoid neoplasm originating in post-germinal B lymphocytes of the extranodal mucosa-associated lymphoid tissue (MALT) of the skin. Its frequency is 7% to 9% of all primary cutaneous lymphomas. It is associated with chronic inflammatory and autoimmune processes. There are four histopathological variants: conventional, lymphoplasmacytic, plasmacytic, and blastoid. Conventional is the most common. It generally affects young adults, often men, and presents as reddish-brown papules, plaques, or nodules on the upper extremities or torso. These can be solitary or multiple. The histomorphology presents a characteristic triad: reactive lymphoid follicles, diffuse infiltration of small lymphocytes, and lymphoepithelial lesions with a morphology similar to Peyer's patches. The conventional variant has an excellent prognosis, with an estimated 5-year survival rate of 98%. Recurrences can occur in 40–50% of patients. The objective is to report an unusual variant of cutaneous lymphoma, with the purpose of emphasizing its inclusion within the differential diagnoses in the approach to lymphoid cutaneous lesions.
We present the clinical case of a 67-year-old female patient who presented with two painful, erythematous, nodular lesions on her left flank, approximately 10 mm in diameter. An excisional biopsy was performed on both specimens, fixed in 10% buffered formalin, embedded in paraffin, and stained with hematoxylin and eosin. Microscopically, the superficial and mid-dermis, and focally the deep dermis, revealed lymphoid proliferation with light and darker areas, whose cells are arranged in nodules and diffuse areas. These cells have medium-sized, hyperchromic nuclei with atypical mitotic figures and scant cytoplasm. Some have larger, vesicular nuclei, while others are lymphoplasmacytoid and plasma cells. Immunohistochemistry was requested, with the following results: CD3: -, CD20: +, BCL2: +, BCL6: -, CD10: -, KI67: 40%, with a diagnosis of cutaneous marginal zone lymphoma.
The rare, usually indolent cutaneous lymphoma is notable for its variability of presentation and the need for an accurate diagnosis for proper treatment and follow-up. |
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