Cutaneous Presentation of Diffuse Large B-Cell Lymphoma.

A 37-year-old male presented with a 2-month-old skin lesion over his chest, which had been increasing in size. He also complained of fatigue and intermittent low-grade fever for the past 3 weeks. He exhibited no other constitutional or systemic symptoms but had pallor and palpable cervical and axillary lymph nodes. His vitals and systemic examination results were normal. He had a hard, non-tender, erythematous, infiltrated plaque (4×5 cm) on the left anterior chest, with local rise in temperature (Figure 1). His blood investigations showed anemia (Hb 8.5 g%). Serum protein electrophoresis showed negative results. Contrast-enhanced CT of the neck, thorax, and abdomen revealed an enlarged thymus, moderate hepatosplenomegaly, and multiple significantly enlarged lymph nodes (mediastinal, cervical, axillary, inguinal and intra-abdominal). Focal lytic osseous lesions were seen in the right iliac bone. Brain MRI showed a few nodular deposits in the occipital region. Skin and bone marrow biopsies were suggestive of stage IV Non-Hodgkin’s lymphoma (NHL) [diffuse large B-cell lymphoma (DLBCL)]. Following the first cycle of chemotherapy [CHOP with rituximab (R-CHOP) regimen], his skin lesion disappeared. Patient is currently on regular follow-up and chemotherapy, and his condition is well.