Primary cutaneous follicle center lymphoma with extensive plasmacytic differentiation and t(14;18) in both the lymphoid and plasma cell components

Primary cutaneous follicle center lymphoma (PCFCL) is the most common B-cell lymphoma. The typical immunophenotype includes expression of both CD20 and BCL6, with majority cases lacking CD10, BCL2, characteristic t(14;18)/IGH-BCL2 rearrangement seen in systemic follicular (FL). Plasmacytic differentiation (PD) an uncommon finding FLs presents a diagnostic challenge when present, leading to potential for misdiagnosis as marginal zone (MZL). Limited reports have described light chain restriction plasma cell component PD, rare PCFCL PD been described. While IGH-BCL2 translocation has identified subset presence BCL2 monotypic cells not previously our knowledge. Here, we report case extensive 77-year-old woman that was favored represent primary MZL on initial punch biopsy. Excisional biopsy, however, revealed atypical lymphocytes expressed while demonstrated light-chain lambda restriction. FISH studies showed lymphocytic plasmacytic components.