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Primary cutaneous CD5+ marginal zone B-cell lymphoma resembling the plasma cell variant of Castleman's disease: Case report

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Tsukamoto N, Kojima M, Uchiyama T, Takeuchi T, Karasawa M, Murakami H, Sato S. Primary cutaneous CD5+ marginal zone B-cell lymphoma resembling the plasma cell variant of Castleman's disease. Case report. APMIS 2007;115:1426–31.

Marginal zone B-cell lymphoma (MZBL) is occasionally associated with prominent plasma cell differentiation. However, MZBL rarely exhibits histological features that resemble plasmacytoma arising from a localized plasma cell variant of Castleman's disease (PCCD). We here report a histologically similar case that was associated with primary cutaneous tumor. The patient was a 57-year-old woman with a 5-year history of cutaneous nodules. Histologically, a prominent proliferation of plasma cells occupied the interfollicular area of the central portion of the cutaneous tumor, whereas various numbers of CD5+ centrocyte-like (CCL) cells, which were arranged in a marginal zone distribution pattern, occupied the peripheral region of the tumor. The majority of the lymphoid follicles had atrophic or regressive germinal centers resembling hyaline-vascular Castleman's disease. CCL cells were observed to have colonized a few of the lymphoid follicles. Immunohistochemistry revealed that these cells had a monotypic intracytoplasmic kappa chain. Without treatment, the patient was quiescent, but 2 years later, there was a transformation to the large cell type. These observations suggest that MZBL needs to be distinguished from PCCD, and that untreated cutaneous MZBL may undergo a high-grade blastic transformation similar to other indolent lymphoproliferative disorders.

Keywords: Castleman's disease; Marginal zone B-cell lymphoma; plasmacytoma; skin; transformation

Document Type: Research Article


Affiliations: 1: Division of Internal Medicine, Takasaki National Hospital, Takasaki 2: Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi 3: Division of Pathology, Gunma Cancer Center Hospital, Ohta, Japan

Publication date: December 1, 2007


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