Image in medicine
Extranodal diffuse large B-cell lymphoma with subcutaneous nodular involvement
Linfoma difuso de células B grandes extranodal con compromiso nodular subcutáneo
Ignacio Martín Santarelli
, Pedro Oscar Manzella, Isabel Sofía Fernández
Corresponding author
Department of Medicine, Hospital de Clínicas “José de San Martín”, Facultad de Medicina, Universidad de Buenos Aires, Argentina
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She had not experienced fever, weight-loss, or diaphoresis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Physical exam was negative for hepatomegaly, splenomegaly or adenopathies. Laboratory was unrevealing, and HIV was negative. Biopsy of one nodule reported a diffuse large B cell lymphoma (DLBCL), not otherwise specified. PET-CT informed multiple cutaneous, subcutaneous, and left amygdalin hypermetabolic involvement (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, Panels B and C). Bone marrow of the axial skeleton showed diffuse enhancement. The stage of the disease was IV.</p><p id="par0015" class="elsevierStylePara elsevierViewall">DLBCL accounts for 30–58% of non-Hodgkin lymphomas. The median age at diagnosis is in the mid-60s. The first clinical sign usually is a quickly growing, painless mass. Extranodal involvement is found in over 50% of the cases, being the most common sites the gastrointestinal tract and bone marrow. Presentation as subcutaneous nodules is rare. FDG-PET/CT scan is the gold standard for staging DLBCL. Over 60% of the patients can be cured with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Initially, differential diagnosis should be made with a wide range of entities that may present with subcutaneous nodular lesions, therefore strengthening the importance of a biopsy sample.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">None to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 748 "Tamanyo" => 81280 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015800000009/v1_202205040537/S0025775321007247/v1_202205040537/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015800000009/v1_202205040537/S0025775321007247/v1_202205040537/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775321007247?idApp=UINPBA00004N" ]
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