Cutaneous Acral Presentation of Indolent Mantle Cell Lymphoma With Prominent Nail Involvement and Atypical Immunophenotype.
Q Wilton Sun, Sebastian A Cruz, Joshua Menke et al.
✦ AI-curated · Sources linked
Case in brief
A 56-year-old healthy male presented with a 5-year history of painful, edematous plaques and nail dystrophy on his bilateral toes. Histopathological examination revealed a multinodular infiltrate of atypical lymphocytes, and immunohistochemistry showed a B-cell population positive for CD20 and BCL2, but negative for CD5 and SOX-11. Diagnosis of indolent mantle cell lymphoma was confirmed through fluorescence in situ hybridization, despite no systemic disease being evident.
What made this case unusual
This case is notable for the absence of typical markers such as CD5 and SOX-11, along with the unique presentation of cutaneous involvement confined to the toes.
Diagnostic / clinical pearl
Clinicians should consider indolent mantle cell lymphoma in patients with atypical cutaneous presentations, especially when common markers are absent.
Why it matters
This case highlights the need for thorough immunophenotypic and molecular evaluation in atypical presentations to avoid misdiagnosis with other cutaneous B-cell lymphomas.