Pathology of Cutaneous B - Lymphoblastic Lymphoma

Primary cutaneous B-lymphoblastic lymphoma most commonly occurs in children and young adults and is characterised by an infiltrate of lymphoblasts which are slightly larger than small lymphocytes but smaller than the blasts of larger of large B-cell lymphoma.

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It appears to be predominantly located in the head and neck region.

These lesions possess round or convoluted nuclei with fine chromatin and inconspicuous nuclei and small amounts of basophilic cytoplasm.

Dermatopathology Quiz Case 179

They are more likely to express CD79a than CD20 and may coexpress CD10. Demonstration of (terminal deoxynucleotidyl transferase ) TdT is useful in differetiating B-lymphoblastic lymphoma from neoplasms of peripheral B-cell.

T-lymphoblastic lymphoma is far more common than B-lymphoblastic lymphoma but the majority of cases involving the skin are of B-cell lineage, suggesting a particular affinity of B-lymphoblastic lymphoma for this site.

Cutaneous involvement may be the presenting features of B-lymphoblastic lymphoma but systemic disease is usually also present when staging is undertaken.

Primary cutaneous B-lymphoblastic lymphoma may mimic Ewing sarcoma or Peripheral primitive neuroectodermal tumours immunophenotypically, and that correct diagnosis in doubtful cases may be facilitated by analysis using a complete panel of antibodies, particularly including TdT and CD43.

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Visit: Pathology of Primary Cutaneous Diffuse Large B-Cell Lymphoma