Concurrent Subcutaneous Panniculitis-like T-Cell Lymphoma and B-Cell Acute Lymphoblastic Leukemia in 2 Pediatric Patients

Subcutaneous panniculitis-like T-cell lymphoma is a cutaneous lymphoma characterized by CD8+ T-cell infiltrate in the subcutis that is rare in children. Acute lymphoblastic lymphoma is the most common pediatric malignancy and often presents with fevers and pancytopenia. Herein, we report 2 pediatric patients presenting with subcutaneous panniculitis-like T-cell lymphoma and B-cell acute lymphoblastic lymphoma, distinct hematologic malignancies arising from different lymphoid lineages, with no identifiable germline cancer predisposition.

Primary cutaneous mantle cell lymphoma with blastic features: report of a rare case with special reference to staging and effectiveness of chemotherapy

We describe a case of blastic primary cutaneous mantle cell lymphoma (MCL) in an 83-year-old male with a complex medical history. The patient presented to his primary care physician with a nodular erythematous skin eruption on his thighs. Histopathologic examination showed a diffuse lymphoid infiltrate of intermediate to large cells that involved the dermis and subcutis but spared the epidermis. Immunohistochemical staining showed expression of CD20, CD5 and cyclin-D1. The lymphoma cells were negative for CD10 and CD23. Fluorescence in situ hybridization (FISH) analysis revealed a characteristic translocation [t(11;14)(q13;q32)], which is diagnostic of MCL. Cutaneous involvement by MCL is typically secondary because of widespread disease, and primary cutaneous MCL can only be diagnosed in the absence of extracutaneous involvement. Primary cutaneous MCL is extremely rare and requires proper clinical staging. In this case, clinical staging revealed no evidence of bone marrow or peripheral blood involvement, and positron emission tomography (PET) scan revealed weak, abnormal uptake only in a few cervical lymph nodes. Because of the lack of disseminated involvement, we favor the lesion to be a primary cutaneous MCL.

An aggressive "double-hit" lymphoma occurring in a 42-year-old male with both MYC and t(14;18) translocations

We describe a 42-year-old male who was in good health until he presented with a high grade B-cell non-Hodgkin lymphoma/leukemia that had both MYC and t(14;18) translocations. This process has now been classified as "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma," according to the 2008 World Health Organization Classification of Tumours of Haematopoitic and Lymphoid Tissues. The clinical presentation, pathologic work-up including examination of the peripheral blood, lymph node biopsy, bone marrow aspiration and biopsy are included. Treatment consisted of seven cycles of chemotherapy following the CALGB protocol 9251. Prognosis is generally reported as poor in these aggressive "double-hit" lymphomas. However, this patient's disease has now been in remission for two years.

A rare case of synchronous invasive ductal carcinoma of the breast and follicular lymphoma

Synchronous presentation of breast cancer and lymphoma is extremely rare. Few cases are reported in the literature. We describe a case of invasive ductal carcinoma of the breast with micrometastasis to a non-sentinel lymph node and subsequent incidental finding of a low-grade follicular lymphoma in an axillary node of a 52-year-old woman. The characteristic immunohistochemical profile of the lymphoma is described.