A case of CD20 positive peripheral T-cell lymphoma: not otherwise specified masquerading as botryomycosis
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20194695Keywords:
Non-Hodgkins lymphoma, CD20, Bacterial pseudomycosis, Immunohistochemistry, T-cell lymphomaAbstract
Peripheral T-cell lymphoma (PTCL), a type of non-Hodgkin’s lymphoma, is an uncommon malignancy frequently involving the skin either as primary or secondary manifestation of the disease. Lymphomas may occasionally masquerade as infectious diseases especially when it is not associated with significant lymphadenopathy. Botryomycosis is a chronic granulomatous suppurative bacterial infection, predominantly caused by Staphylococcus aureus, which is seen on trauma prone sites. Herein we present a case of a 33 years old male who presented to us with multiple rapidly growing friable masses on the chest wall of six weeks duration which clinically pointed towards botryomycosis. Lack of response to treatment with intravenous antibiotics and absence of grains and granuloma in the biopsy specimen made us further proceed for immune-histochemical evaluation which confirmed a rare type of CD20 positive PTCL. In conclusion, our case alerts physician to maintain a high index of suspicion for unusual entities in cases they encounter, cases with unusual presentation or atypical response to treatment.
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References
Bonifaz A, Carrasco E. Botryomycosis. Int J Dermatol. 1996;35:381-8.
Nemani S, Korula A, Agrawal B, Kavitha ML, Manipadam MT, Sigamani E, et al. Peripheral T cell lymphoma: Clinico-pathological characteristics & outcome from a tertiary care centre in south India. Indian J Med Res. 2018;147:464-70.
Wallett A, Ibbetson JS, Kearney D, Newland K, Sidhu S. Cutaneous manifestations of peripheral T-cell lymphoma, not otherwise specified: A case series highlighting the diagnostic challenges for this heterogeneous group. Australas J Dermatol. 2015;56(3):197-201.
Vose J, Armitage J, Weisenburger D; International T-Cell Lymphoma Project. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol. 2008;26(25):4124-30.
Tolkachjov SN, Weenig RH, Comfere NI. Cutaneous peripheral T-cell lymphoma, not otherwise specified: A single-center prognostic analysis. J Am Acad Dermatol. 2016;75(5):992-9.
Rezania D, Sokol L, Cualing HD. Classification and treatment of rare and aggressive types of peripheral T-cell/natural killer-cell lymphomas of the skin. Cancer Control. 2007;14:112-23.
Bekkenk MW, Vermeer MH, Jansen PM, van Marion AM, Dijk MRC, Kluin PM, et al. Peripheral T-cell lymphomas unspecified presenting in the skin: Analysis of prognostic factors in a group of 82 patients. Blood. 2003;102:2213-9.
Balmer NN, Hughey L, Busam KJ, Reddy V, Andea AA. Primary cutaneous peripheral T-cell lymphoma with aberrant coexpression of CD20: case report and review of the literature. Am J Dermatopathol. 2009;31:187-92.
Sen F, Kang S, Cangiarella J, Kamino H, Hymes K. CD20 positive mycosis fungoides: a case report. J Cutan Pathol. 2008;35:398-403.
Buckner CL, Christiansen LR, Bourgeois D, Lazarchick JJ, Lazarchick J. CD20 positive T-cell lymphoma/leukemia: a rare entity with potential diagnostic pitfalls. Ann Clin Lab Sci. 2007;37:263-67.
