CD20 Negative Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type with Rapidly Progressing Skin Lesions

Abstract

A 95-year-old man came with violaceous nodular skin lesions of the left shin. The lesions were not painful or pruritic but progressed  rapidly over the 3 months. Fever, night sweats, weight loss, and other systemic symptoms were absent. Shave biopsy of the lesion  revealed the cells negative for CD20 but positive for BCL2, BCL6, FOX-P1, and CD10. PET/CT showed high uptake in the left leg and a  sizeable hypermetabolic lymph node in the left pelvis. The patient was started on rituximab treatment as a single agent. This report   highlights some of the diagnostic and treatment difficulties in CD20 negative lymphomas and the importance of a multidisciplinary  approach in those cases.