Isolated cutaneous intravascular large B cell lymphoma masquerading as panniculitis: A rare case report with review of literature

Abstract

Abstract

lntravascular large B-cell lymphoma (IVLBCL)is a rare type of extranodal large B-cell lymphoma characterized by the selective growth of lymphoma cells within the lumina of vessels, in particular capillaries, and with the exception of larger arteries and veins. Isolated cutaneous variant of IVLBVL is rare and seen in western countries. Here we present one such case which clinically masqueraded as pannicultis. Here we present a case report of a 62 years old lady, who presented with multiple erythematous tender indurated plaques with overlying and surrounding telangiectasia seen over thighs, abdomen and right breast for 6 months which initially started in the left thigh. Biopsy of skin lesion from anterior abdominal wall was done showed features of intravascular large B cell lymphoma which was confirmed by immunohistochemistry. Isolated cutaneous variant accounts for 25% of the total IVLBCLs and presents with single or multiple skin lesions without systemic involvement. This variant is seen at a younger age and common in western females and show better prognosis than classical IVLBCL and is rare in Asian countries. The cutaneous variant is difficult to diagnose clinically as the findings may mimic lesions of thrombophlebitis, erysipelas or erythema nodosum etc, hence may cause delay in diagnosis. Prognosis is better if early intervention with skin biopsy done. The case is presented here for its rarity and to emphasize on importance of skin biopsy examination in suspicious cases so that early treatment can be given.