TY - JOUR
T1 - Case report
T2 - An unusual observation of elastophagocytosis in a patient with cutaneous CD5+ diffuse large B cell lymphoma
AU - Ohtsuki, Yuji
AU - Matsuka, Yuki
AU - Tanihata, Wakana
AU - Izumimoto, Masako
AU - Okada, Yuhei
AU - Lee, Gang Hong
AU - Furihata, Mutsuo
AU - Takata, Katsuyoshi
AU - Yoshino, Tadashi
PY - 2013/10/25
Y1 - 2013/10/25
N2 - A Japanese man in his mid-60s reported having a subcutaneous mass for a period of 8 months, after which it gradually enlarged in size and was surgically extirpated. The resected tumor was 10 × 8 mm in size, and the cut surface was smooth, solid, and whitish. Histologi-cal analysis revealed the presence of medium to large lymphoid cells that had proliferated to form a solid mass. The diffuse proliferating cells stained positive for CD20, CD79a, and CD5, but were negative for CD3, CD30, and CD10, and the MIB-1 index was very high. On the basis of these findings, the tumor was diagnosed as cutaneous CD5+ diffuse large B cell lym-phoma. Interestingly, detailed analysis revealed elastophagocytosis, with scattered, fragmented elastic fibers engulfed by macrophages that were intermixed with tumor cells. These macrophages were mostly multinucleated giant cells, apparently forming part of a foreign body-type reaction. Elastic fiber staining clearly revealed positively stained fragmented fibers in the cytoplasm of the macrophages, which were densely positive for CD68, in sharp contrast to the CD68-negative tumor cells. The final diagnosis was cutaneous CD5+ diffuse large B cell lymphoma exhibiting unusual elastophagocytosis. The patient's clinical course was good, and the tumor disappeared completely after 3 cycles of rituximab, cyclophos-phamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy with radiation.
AB - A Japanese man in his mid-60s reported having a subcutaneous mass for a period of 8 months, after which it gradually enlarged in size and was surgically extirpated. The resected tumor was 10 × 8 mm in size, and the cut surface was smooth, solid, and whitish. Histologi-cal analysis revealed the presence of medium to large lymphoid cells that had proliferated to form a solid mass. The diffuse proliferating cells stained positive for CD20, CD79a, and CD5, but were negative for CD3, CD30, and CD10, and the MIB-1 index was very high. On the basis of these findings, the tumor was diagnosed as cutaneous CD5+ diffuse large B cell lym-phoma. Interestingly, detailed analysis revealed elastophagocytosis, with scattered, fragmented elastic fibers engulfed by macrophages that were intermixed with tumor cells. These macrophages were mostly multinucleated giant cells, apparently forming part of a foreign body-type reaction. Elastic fiber staining clearly revealed positively stained fragmented fibers in the cytoplasm of the macrophages, which were densely positive for CD68, in sharp contrast to the CD68-negative tumor cells. The final diagnosis was cutaneous CD5+ diffuse large B cell lymphoma exhibiting unusual elastophagocytosis. The patient's clinical course was good, and the tumor disappeared completely after 3 cycles of rituximab, cyclophos-phamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy with radiation.
KW - CD5
KW - Cutaneous lymphoma
KW - Diffuse large B cell lymphoma
KW - Elastophagocytosis
KW - Macrophage
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M3 - Article
AN - SCOPUS:84886941356
VL - 24
SP - 521
EP - 524
JO - Biomedical Research
JF - Biomedical Research
SN - 0970-938X
IS - 4
ER -