Abstract

Lbarrah Fatima Zahra*, Aghoutane Yossra, Benlachgar Naoufal, Haidouri Soukaina, Tazi Mezalek Zoubida

ABSTRACT

Background: Primary cutaneous follicle centre lymphoma (PCFCL) is an indolent subtype of B-cell lymphoma confined to the skin, without evidence of systemic involvement. It typically follows a benign course and responds well to local or systemic therapy. Case presentation: We report the case of a 57-year-old man who presented with a one-year history of vesicular plaques on the chest, which evolved into a large ulcerated lesion. Physical examination revealed a single ulcer on the trunk, without lymphadenopathy or systemic symptoms. Laboratory findings, including complete blood count and lactate dehydrogenase levels, were within normal limits. Serological tests for hepatitis B and C, HIV, and syphilis were negative. Histopathological examination of two skin biopsies demonstrated a diffuse and follicular proliferation of large lymphoid cells. Immunohistochemistry revealed positivity for CD20 and BCL6, and negativity for CD10, BCL2, MUM1, CD5, and EBV, consistent with the diagnosis of PCFCL. A CT scan showed extension to the anterior mediastinum, without other secondary localizations. The patient was treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), achieving complete remission. After three years of follow-up, the patient remains disease-free. Conclusion: This case illustrates the favourable prognosis of primary cutaneous follicle centre lymphoma, even in cases with mediastinal extension. R-CHOP therapy can lead to durable remission in patients with extensive disease.