두피에 발생한 피부 원발성 여포성 B세포 림프종

Abstract

Primary cutaneous follicular B cell lymphomas are rare entities of an unknown cause, except for those induced by Epstein-Barr virus (EBV) or Borrelia burgdorferi. Follicular B cell lymphoma has been thought to rarely occur primarily in the skin. The lesions are generally solitary plaques or nodules that are localized on the head and neck. It shows considerable variation in the clinical presentation, the histological features, the immunophenotype and the prognosis. In this case, a 79-year-old man presented with a 3-month history of lesions on his head. Clinical examination revealed two deep-seated subcutaneous tumors with uneven surfaces located on the both sides of the frontoparietal area of the scalp. Biopsy of the skin lesion disclosed a massive dermal lymphocytic infiltrate with a follicular pattern. On immunohistochemical staining, the lymphocytes strongly expressed CD20 and Ki-67, but not Bcl-2. He was diagnosed with primary cutaneous follicular B cell lymphoma. This case illustrates a rarely reported example of primary cutaneous follicular B cell lymphoma that arose on the scalp. (Korean J Dermatol 2011;49(6):506∼510)