Case Number : Case 379 Posted By: Guest

Phillip McKee - Overseas Consultations (Cave Creek, Arizona, USA) Wrote:

I completely agree that immunohistochemistry is necessary to come to a definitive diagnosis which in this case was primary cutaneous follicle center cell lymphoma. I do not think that a diagnosis of tumor stage mycosis fungoides is appropriate as that almost invariably shows high grade features with numerous blast cells. I have seen a few cases of Hodgkin lymphoma in the skin and Reed Sternberg cells were easy to see and numerous eosinophils were present. In marginal zone lymphoma one would hope to see residual germinal centers rather than neoplastic follicles although the distinction can be difficult if there is complete colonization of the follicles.

Submitted on 22/11/2011 15:38
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Pablo Ortega - "Isidro Ayora" Hospital (Loja-Ecuador) Wrote:

B cell lymphoma, Follicular centre!

Submitted on 22/11/2011 14:42
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Zena Slim (SpR Histopath) - Wessex Deanery (Queen Alexandra Hospital Portsmouth) Wrote:

This is a cutaneous lymphoma showing a dense and diffuse pattern. Epidermotropism is absent. The vasculature is conspicuous. The malignant cells are small and appear to resemble mycosis/Sezary cells. Immunohistochemistry is needed but I would have Tumour-stage Mycosis Fungoides at the top of my list of differentials. Other small cell lymphomas enter the list of course. Any history of MF?

Submitted on 22/11/2011 14:19
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Mona Abdel Halim - Dermatology Dept., Cairo Univ. (Egypt) Wrote:

B cell lymphoma, Follicular centre, diffuse type

Submitted on 22/11/2011 11:25
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A Bansal - BCU HB (North Wales) Wrote:

Lymphoma, NOS. Needs immunos.

Submitted on 22/11/2011 09:48
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I. Abdul-kadir - SJUH (Leeds, UK) Wrote:

A small, B-cell type (non-epidermotropic) lymphoma, e.g. diffuse follicle center lymphoma or marginal zone lymphoma.

Submitted on 22/11/2011 09:20
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Rodrigo Restrepo - UPB/CES (Mdlln/COL) Wrote:

Follicular B cell lymphoma

Submitted on 22/11/2011 07:36
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

B cell lymphoma (follicular centre !!) for immunos.

Submitted on 22/11/2011 07:21
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Hazem Hamed - Department of Histopathology, Imperial College (London) Wrote:

There is a vague nodular pattern (3rd images) and the infiltrate is dense and comprises small lymphoid cells with irregular nuclei (centrocyte-like) and larger cells (centroblast/centroblast-like/prolymphocyte). D is Low grade lymphoma for immuno (Cd20, Cd3, BCL2, BCL6, CD10, Cd23, CD5, cyclin D1, IgD, IgM, Igk, Iglambda). DD includes, follicular lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukaemia, marginal zone lymphoma and mantle cell lymphoma.

Submitted on 22/11/2011 05:21
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Peter Karolyi - () Wrote:

I think it is B cells malignant lymphoma, (CLL?) Some larger cells, reminiscent of Hodgkin-cells ( but no eosinophils). Hodgkins lymphoma can be a diff dg but not in the first place.

Submitted on 22/11/2011 05:15
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Sasi Attili - (UK) Wrote:

Looks like a lymphoma. I find it quite difficult to make the diagnosis without immunos. However the presence of large pleomorphic cells with vesicular nuclei in makes me wonder if this is an anaplastic large T-cell lymphoma or a Diffuse large B-cell lymphoma.

Submitted on 22/11/2011 04:58
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