Fulvio Massaro1, Angela Ferrari2, Enrico Zendri3, Magda Zanelli3, Francesco Merli2. 1. Hematology, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy. fulvio.massaro@ausl.re.it. 2. Hematology, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy. 3. Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, Reggio Emilia 42123, Italy.
Abstract
BACKGROUND: Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding. Few cases have been reported in literature, most describing paraneoplastic manifestations. Only very few papers have described primary HL skin infiltration, reporting a wide range of clinical presentations that frequently include ulcers; plaques, nodules and papules have also been noticed. CASE SUMMARY: We report the case of a 56-year-old man who presented fever, multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions. After an initial diagnostic workup for a suspected active infectious disease, a lymph node biopsy was performed, which showed a neoplastic invasion from a mixed cellularity classical HL. The same histological pattern was described in a cutaneous biopsy of the chest lesions. The other staging procedures performed revealed an advanced disease, with unfavourable clinical prognostic features. The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin, bleomycin, vinblastine, dacarbazine), a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy. CONCLUSION: Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.
BACKGROUND: Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding. Few cases have been reported in literature, most describing paraneoplastic manifestations. Only very few papers have described primary HL skin infiltration, reporting a wide range of clinical presentations that frequently include ulcers; plaques, nodules and papules have also been noticed. CASE SUMMARY: We report the case of a 56-year-old man who presented fever, multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions. After an initial diagnostic workup for a suspected active infectious disease, a lymph node biopsy was performed, which showed a neoplastic invasion from a mixed cellularity classical HL. The same histological pattern was described in a cutaneous biopsy of the chest lesions. The other staging procedures performed revealed an advanced disease, with unfavourable clinical prognostic features. The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin, bleomycin, vinblastine, dacarbazine), a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy. CONCLUSION: Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.
Entities:
Keywords:
ABVD; Advanced stage; Case report; Hodgkin lymphoma; Skin lesions
Authors: Stephanie Saavedra-Portales; Luis A Mena; Fernando A Valenzuela; Laura E Carreño; Willybaldo Saavedra-Portales Journal: Indian J Dermatol Date: 2022 Jan-Feb Impact factor: 1.757