2022 Volume 21 Issue 4 Pages 300-306
A 91-year-old man presented with variously-sized, oval, red masses on bilateral lower legs. Histopathologically, atypical large lymphocytes were diffusely and densely infiltrated from just below the epidermis to the middle dermis. Immunohistochemically, tumor cells were positive for CD20,BCL2, MUM1, and C-MYC, and negative for CD10 and BCL6. Ki-67 proliferation index was85%. We diagnosed diffuse large B-cell lymphoma, non-GCB type. Detailed medical interview revealed a history of primary nasal diffuse large B-cell lymphoma 7 years ago. A recurred lesion was detected in the nasal cavity. We concluded that the present case was consistent with a recurrence to the nasal cavity and an infiltration to the lower legs by nasal diffuse large B-cell lymphoma. We administered a combination regimen with rituximab ＋ THP-COP in consideration of past treatment and his age. After two courses of THP-COP, the masses had shrunk. However, additional courses could not be continued because of diarrhea. Treatment with prednisolone and etoposide in addition to local irradiation therapy brought a further therapeutic effect. Although the patient waselderly and had a poor prognosis factor in immunohistochemistry, chemoradiotherapy was efficacious. Skin Research, 21 : 300-306, 2022
