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Transient wheal attack corresponding to the tumor lesions of primary cutaneous diffuse large B cell lymphoma, leg type after successive rituximab treatment.

Itoi S, Tanemura A, Hayashi M, Nagata N, Tani M, Katayama I - Case Rep Dermatol (2014)

Bottom Line: An elderly male noticed urticarial patches corresponding to cutaneous B cell lymphoma lesions after rituximab treatment.Along with the resolution of urticaria, the lymphoma lesions completely remitted without recurrence.In this communication, we present an interesting case and the pathophysiological findings of a wheal attack in a case with tumor remission following systemic treatment with rituximab, a monoclonal anti-CD20 antibody.

View Article: PubMed Central - PubMed

Affiliation: Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.

ABSTRACT
An elderly male noticed urticarial patches corresponding to cutaneous B cell lymphoma lesions after rituximab treatment. Along with the resolution of urticaria, the lymphoma lesions completely remitted without recurrence. In this communication, we present an interesting case and the pathophysiological findings of a wheal attack in a case with tumor remission following systemic treatment with rituximab, a monoclonal anti-CD20 antibody.

No MeSH data available.


Related in: MedlinePlus

a Clinical features at first hospitalization. Finger- to fist-sized indurative and erythematous plaques were noted throughout the left lower leg. b, c Histopathological features at first medical examination. Bars = 250 μm (b) and 50 μm (c). A grenz zone was notable, and dense infiltration of lymphoid cells with large-scaled nuclei was identified throughout the entire dermis. Most of these were centrocyte-like cells. d The infiltrated lymphoid cells were positive for CD20. Bar = 250 μm. e Clinical features 2 h after rituximab administration. f Clinical features of the complete remission of PCDLBCL-LT 20 days after rituximab administration. g Histopathological features at the time of complete remission of PCDLBCL-LT. Bar = 250 μm.
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Figure 1: a Clinical features at first hospitalization. Finger- to fist-sized indurative and erythematous plaques were noted throughout the left lower leg. b, c Histopathological features at first medical examination. Bars = 250 μm (b) and 50 μm (c). A grenz zone was notable, and dense infiltration of lymphoid cells with large-scaled nuclei was identified throughout the entire dermis. Most of these were centrocyte-like cells. d The infiltrated lymphoid cells were positive for CD20. Bar = 250 μm. e Clinical features 2 h after rituximab administration. f Clinical features of the complete remission of PCDLBCL-LT 20 days after rituximab administration. g Histopathological features at the time of complete remission of PCDLBCL-LT. Bar = 250 μm.

Mentions: A 73-year-old male presented to our department in January 2010 with a 7-year history of erythematous skin patches on his left lower leg which had not improved after the use of topical steroids. At initial physical examination, erythema and red-to-brown-colored, various-sized cutaneous nodules were found on the bilateral lower legs (fig. 1a). Histological study showed dense infiltration of lymphoid cells with irregular nuclei in the superficial and deep dermis (fig. 1b, c), and immunohistological staining revealed that most of the infiltrating lymphoid cells were positive for CD20 (fig. 1d). The patient had no fever, weight loss or night sweats. Whole body imaging studies and bone marrow histopathology did not detect metastatic or disseminated disease. Based on these results, we diagnosed the patient with PCDLBCL-LT, which was stage IB according to the WHO-EORTC classification.


Transient wheal attack corresponding to the tumor lesions of primary cutaneous diffuse large B cell lymphoma, leg type after successive rituximab treatment.

Itoi S, Tanemura A, Hayashi M, Nagata N, Tani M, Katayama I - Case Rep Dermatol (2014)

a Clinical features at first hospitalization. Finger- to fist-sized indurative and erythematous plaques were noted throughout the left lower leg. b, c Histopathological features at first medical examination. Bars = 250 μm (b) and 50 μm (c). A grenz zone was notable, and dense infiltration of lymphoid cells with large-scaled nuclei was identified throughout the entire dermis. Most of these were centrocyte-like cells. d The infiltrated lymphoid cells were positive for CD20. Bar = 250 μm. e Clinical features 2 h after rituximab administration. f Clinical features of the complete remission of PCDLBCL-LT 20 days after rituximab administration. g Histopathological features at the time of complete remission of PCDLBCL-LT. Bar = 250 μm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4209260&req=5

Figure 1: a Clinical features at first hospitalization. Finger- to fist-sized indurative and erythematous plaques were noted throughout the left lower leg. b, c Histopathological features at first medical examination. Bars = 250 μm (b) and 50 μm (c). A grenz zone was notable, and dense infiltration of lymphoid cells with large-scaled nuclei was identified throughout the entire dermis. Most of these were centrocyte-like cells. d The infiltrated lymphoid cells were positive for CD20. Bar = 250 μm. e Clinical features 2 h after rituximab administration. f Clinical features of the complete remission of PCDLBCL-LT 20 days after rituximab administration. g Histopathological features at the time of complete remission of PCDLBCL-LT. Bar = 250 μm.
Mentions: A 73-year-old male presented to our department in January 2010 with a 7-year history of erythematous skin patches on his left lower leg which had not improved after the use of topical steroids. At initial physical examination, erythema and red-to-brown-colored, various-sized cutaneous nodules were found on the bilateral lower legs (fig. 1a). Histological study showed dense infiltration of lymphoid cells with irregular nuclei in the superficial and deep dermis (fig. 1b, c), and immunohistological staining revealed that most of the infiltrating lymphoid cells were positive for CD20 (fig. 1d). The patient had no fever, weight loss or night sweats. Whole body imaging studies and bone marrow histopathology did not detect metastatic or disseminated disease. Based on these results, we diagnosed the patient with PCDLBCL-LT, which was stage IB according to the WHO-EORTC classification.

Bottom Line: An elderly male noticed urticarial patches corresponding to cutaneous B cell lymphoma lesions after rituximab treatment.Along with the resolution of urticaria, the lymphoma lesions completely remitted without recurrence.In this communication, we present an interesting case and the pathophysiological findings of a wheal attack in a case with tumor remission following systemic treatment with rituximab, a monoclonal anti-CD20 antibody.

View Article: PubMed Central - PubMed

Affiliation: Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.

ABSTRACT
An elderly male noticed urticarial patches corresponding to cutaneous B cell lymphoma lesions after rituximab treatment. Along with the resolution of urticaria, the lymphoma lesions completely remitted without recurrence. In this communication, we present an interesting case and the pathophysiological findings of a wheal attack in a case with tumor remission following systemic treatment with rituximab, a monoclonal anti-CD20 antibody.

No MeSH data available.


Related in: MedlinePlus