A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea / 대한피부과학회지

ABSTRACT

Precursor B-cell lymphoblastic lymphoma is a rare type of non-Hodgkin's lymphoma seen exclusively in children and young adults. The neoplasm is rare in old age. We report a case of a 58-year-old male, who presented with variable-sized, erythematous to brownish papules and plaques on the scalp and face. There were no other symptoms. Pathological examination showed non-specific, sparse superficial and deep perivascular lymphocyte infiltration. We diagnosed the condition as rosacea and prescribed 100 mg of minocycline per day for 10 days. When he was seen 10 days later, his skin lesions were aggravated and re-biopsy was completed. Histopathology revealed diffuse infiltrates of small to medium-sized lymphoid cells with blastic nuclear chromatin and a high mitotic rate. Immunohistochemical study showed that infiltrated lymphoid cells were precursor B-cell type. Physical examination and staging work-up revealed extensive involvement of lymphoma in bilateral kidney, heart, pancreas, axial and proximal appendicular bones, scalp and cervical lymph node. The patient is being treated with combination chemotherapy.