Case report: An unusual observation of elastophagocytosis in a patient with cutaneous CD5+ diffuse large B cell lymphoma

Yuji Ohtsuki, Yuki Matsuka, Wakana Tanihata, Masako Izumimoto, Yuhei Okada, Gang Hong Lee, Mutsuo Furihata, Katsuyoshi Takata, Tadashi Yoshino

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)521-524
Number of pages4
JournalBiomedical Research (India)
Volume24
Issue number4
Publication statusPublished - Oct 25 2013

Keywords

  • CD5
  • Cutaneous lymphoma
  • Diffuse large B cell lymphoma
  • Elastophagocytosis
  • Macrophage

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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    Ohtsuki, Y., Matsuka, Y., Tanihata, W., Izumimoto, M., Okada, Y., Lee, G. H., Furihata, M., Takata, K., & Yoshino, T. (2013). Case report: An unusual observation of elastophagocytosis in a patient with cutaneous CD5+ diffuse large B cell lymphoma. Biomedical Research (India), 24(4), 521-524.