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Primary cutaneous CD5+ marginal zone B‐cell lymphoma resembling the plasma cell variant of Castleman's disease
Author(s) -
TSUKAMOTO NORIFUMI,
KOJIMA MASARU,
UCHIYAMA TOSHIMASA,
TAKEUCHI TOKIO,
KARASAWA MASAMITSU,
MURAKAMI HIROKAZU,
SATO SADAO
Publication year - 2007
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1600-0463.2007.00797.x
Subject(s) - pathology , plasma cell , germinal center , cd5 , lymphoma , marginal zone , lymphatic system , hyaline , mantle zone , medicine , b cell , biology , antibody , immunology , bone marrow
Marginal zone B‐cell lymphoma (MZBL) is occasionally associated with prominent plasma cell differentiation. However, MZBL rarely exhibits histological features that resemble plasmacytoma arising from a localized plasma cell variant of Castleman's disease (PCCD). We here report a histologically similar case that was associated with primary cutaneous tumor. The patient was a 57‐year‐old woman with a 5‐year history of cutaneous nodules. Histologically, a prominent proliferation of plasma cells occupied the interfollicular area of the central portion of the cutaneous tumor, whereas various numbers of CD5+ centrocyte‐like (CCL) cells, which were arranged in a marginal zone distribution pattern, occupied the peripheral region of the tumor. The majority of the lymphoid follicles had atrophic or regressive germinal centers resembling hyaline‐vascular Castleman's disease. CCL cells were observed to have colonized a few of the lymphoid follicles. Immunohistochemistry revealed that these cells had a monotypic intracytoplasmic kappa chain. Without treatment, the patient was quiescent, but 2 years later, there was a transformation to the large cell type. These observations suggest that MZBL needs to be distinguished from PCCD, and that untreated cutaneous MZBL may undergo a high‐grade blastic transformation similar to other indolent lymphoproliferative disorders.