Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso

Detalhes bibliográficos
Autor(a) principal: Antunes, Ana Patrícia Barbosa
Data de Publicação: 2025
Outros Autores: Macedo de Magalhães, Ana Filipa, Viseu dos Santos, André Filipe, Ribeiro Soares Vieira, Álvaro Filipe, Borges Correlo, Carla Maria
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: https://doi.org/10.32385/rpmgf.v41i2.14046
Resumo: Introduction: Primary cutaneous lymphomas are defined as a heterogeneous group of malignant lymphoproliferative neoplasms that affect the skin, without extracutaneous involvement at the moment of the diagnosis. Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBL-LT) represents a subgroup of these tumours. This clinical case illustrates the difficulty of diagnosing this condition, in which the family doctor (FD) played a crucial role. Case report: A 75-year-old woman, after undergoing drainage of a liquid collection in her right ankle in a private clinic, consulted the FD due to persistent drainage, oedema, and redness after several cycles of antibiotic therapy. She was referred to urgent evaluation by general surgery, which ruled out a surgical complication. In a new consultation with her FD to assess the evolution of the lesion, it showed worsening with ulceration and hypoesthesia, raising the suspicion of the skin or soft tissue tumour. After additional diagnostic tests, such as a joint CT scan that described a “fracture involving the distal peroneal diaphysis associated with swelling of soft tissues”, the patient was referred to an urgent orthopaedics consultation and after a biopsy of the lesion, she was diagnosed with PCDLBL-LT. The patient started an R-CHOP regimen followed by radiotherapy. Comment: This case illustrates the difficulty in diagnosing a primary cutaneous lymphoma. Close follow-up of the patient during numerous consultations was essential to make the diagnosis of a neoplastic disease. Considering its rapid growth and high proliferative rate, it is important to know its clinical presentation for a precocious diagnosis and efficient treatment.
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spelling Linfoma cutâneo primário difuso de grandes células B, leg type: relato de casoPrimary cutaneous diffuse large B-cell lymphoma, leg type: case reportLymphomaDiffuse large B-cellLeg typeSkin neoplasmsCase reportLinfoma difuso de grandes células BLeg typeNeoplasia cutâneaRelato de casoIntroduction: Primary cutaneous lymphomas are defined as a heterogeneous group of malignant lymphoproliferative neoplasms that affect the skin, without extracutaneous involvement at the moment of the diagnosis. Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBL-LT) represents a subgroup of these tumours. This clinical case illustrates the difficulty of diagnosing this condition, in which the family doctor (FD) played a crucial role. Case report: A 75-year-old woman, after undergoing drainage of a liquid collection in her right ankle in a private clinic, consulted the FD due to persistent drainage, oedema, and redness after several cycles of antibiotic therapy. She was referred to urgent evaluation by general surgery, which ruled out a surgical complication. In a new consultation with her FD to assess the evolution of the lesion, it showed worsening with ulceration and hypoesthesia, raising the suspicion of the skin or soft tissue tumour. After additional diagnostic tests, such as a joint CT scan that described a “fracture involving the distal peroneal diaphysis associated with swelling of soft tissues”, the patient was referred to an urgent orthopaedics consultation and after a biopsy of the lesion, she was diagnosed with PCDLBL-LT. The patient started an R-CHOP regimen followed by radiotherapy. Comment: This case illustrates the difficulty in diagnosing a primary cutaneous lymphoma. Close follow-up of the patient during numerous consultations was essential to make the diagnosis of a neoplastic disease. Considering its rapid growth and high proliferative rate, it is important to know its clinical presentation for a precocious diagnosis and efficient treatment.Introdução: Os linfomas cutâneos primários são um grupo heterogéneo de neoplasias malignas linfoproliferativas que acometem a pele, sem evidência de envolvimento extracutâneo no momento do diagnóstico. O linfoma cutâneo primário difuso de grandes células B, leg type (LCPDCB, LT) representa um subgrupo destas neoplasias. Este caso clínico ilustra a dificuldade de diagnóstico da patologia, no qual o médico de família (MF) desempenhou um papel crucial. Descrição do caso: Mulher de 75 anos que, após ser submetida a drenagem de coleção líquida no tornozelo direito em regime privado, recorre a consulta com o MF por manter drenagem, edema e rubor após vários ciclos de antibioterapia. Foi encaminhada para avaliação urgente por cirurgia geral, que descartou complicação cirúrgica. Em nova consulta com o MF para avaliação da evolução da lesão apresentava agravamento com ulceração e alteração da sensibilidade associada, levantando a suspeita de neoplasia da pele ou partes moles. Após a realização de exames complementares de diagnóstico, nomeadamente TAC articular, que descrevia “fratura envolvendo a diáfise peroneal distal associada a uma tumefação de partes moles”, a utente foi referenciada para consulta urgente de ortopedia e diagnosticada com LCPDCB, LT após biópsia da lesão. A utente iniciou esquema de seis ciclos de CHOP-R, seguido de radioterapia. Comentários: Este caso clínico ilustra a dificuldade no diagnóstico que pode acarretar um linfoma cutâneo primário. O seguimento da utente ao longo das várias consultas foi essencial para se colocar a hipótese diagnóstica de doença neoplásica. Considerando o crescimento rápido da lesão e o alto índice proliferativo é importante conhecer a apresentação clínica para, assim, realizar o diagnóstico precoce e instituir o tratamento efetivo.Associação Portuguesa de Medicina Geral e Familiar2025-05-15info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v41i2.14046https://doi.org/10.32385/rpmgf.v41i2.14046Portuguese Journal of Family Medicine and General Practice; Vol. 41 No. 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-72Revista Portuguesa de Medicina Geral e Familiar; Vol. 41 Núm. 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-72Revista Portuguesa de Medicina Geral e Familiar; Vol. 41 N.º 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-722182-51812182-517310.32385/rpmgf.v41i2reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/14046https://rpmgf.pt/ojs/index.php/rpmgf/article/view/14046/12036Direitos de Autor (c) 2025 Revista Portuguesa de Medicina Geral e Familiarinfo:eu-repo/semantics/openAccessAntunes, Ana Patrícia BarbosaMacedo de Magalhães, Ana FilipaViseu dos Santos, André FilipeRibeiro Soares Vieira, Álvaro FilipeBorges Correlo, Carla Maria2025-05-17T11:35:20Zoai:ojs.rpmgf.pt:article/14046Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T07:35:07.933120Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
Primary cutaneous diffuse large B-cell lymphoma, leg type: case report
title Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
spellingShingle Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
Antunes, Ana Patrícia Barbosa
Lymphoma
Diffuse large B-cell
Leg type
Skin neoplasms
Case report
Linfoma difuso de grandes células B
Leg type
Neoplasia cutânea
Relato de caso
title_short Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
title_full Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
title_fullStr Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
title_full_unstemmed Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
title_sort Linfoma cutâneo primário difuso de grandes células B, leg type: relato de caso
author Antunes, Ana Patrícia Barbosa
author_facet Antunes, Ana Patrícia Barbosa
Macedo de Magalhães, Ana Filipa
Viseu dos Santos, André Filipe
Ribeiro Soares Vieira, Álvaro Filipe
Borges Correlo, Carla Maria
author_role author
author2 Macedo de Magalhães, Ana Filipa
Viseu dos Santos, André Filipe
Ribeiro Soares Vieira, Álvaro Filipe
Borges Correlo, Carla Maria
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Antunes, Ana Patrícia Barbosa
Macedo de Magalhães, Ana Filipa
Viseu dos Santos, André Filipe
Ribeiro Soares Vieira, Álvaro Filipe
Borges Correlo, Carla Maria
dc.subject.por.fl_str_mv Lymphoma
Diffuse large B-cell
Leg type
Skin neoplasms
Case report
Linfoma difuso de grandes células B
Leg type
Neoplasia cutânea
Relato de caso
topic Lymphoma
Diffuse large B-cell
Leg type
Skin neoplasms
Case report
Linfoma difuso de grandes células B
Leg type
Neoplasia cutânea
Relato de caso
description Introduction: Primary cutaneous lymphomas are defined as a heterogeneous group of malignant lymphoproliferative neoplasms that affect the skin, without extracutaneous involvement at the moment of the diagnosis. Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBL-LT) represents a subgroup of these tumours. This clinical case illustrates the difficulty of diagnosing this condition, in which the family doctor (FD) played a crucial role. Case report: A 75-year-old woman, after undergoing drainage of a liquid collection in her right ankle in a private clinic, consulted the FD due to persistent drainage, oedema, and redness after several cycles of antibiotic therapy. She was referred to urgent evaluation by general surgery, which ruled out a surgical complication. In a new consultation with her FD to assess the evolution of the lesion, it showed worsening with ulceration and hypoesthesia, raising the suspicion of the skin or soft tissue tumour. After additional diagnostic tests, such as a joint CT scan that described a “fracture involving the distal peroneal diaphysis associated with swelling of soft tissues”, the patient was referred to an urgent orthopaedics consultation and after a biopsy of the lesion, she was diagnosed with PCDLBL-LT. The patient started an R-CHOP regimen followed by radiotherapy. Comment: This case illustrates the difficulty in diagnosing a primary cutaneous lymphoma. Close follow-up of the patient during numerous consultations was essential to make the diagnosis of a neoplastic disease. Considering its rapid growth and high proliferative rate, it is important to know its clinical presentation for a precocious diagnosis and efficient treatment.
publishDate 2025
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dc.relation.none.fl_str_mv https://rpmgf.pt/ojs/index.php/rpmgf/article/view/14046
https://rpmgf.pt/ojs/index.php/rpmgf/article/view/14046/12036
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2025 Revista Portuguesa de Medicina Geral e Familiar
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rights_invalid_str_mv Direitos de Autor (c) 2025 Revista Portuguesa de Medicina Geral e Familiar
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publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
dc.source.none.fl_str_mv Portuguese Journal of Family Medicine and General Practice; Vol. 41 No. 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-72
Revista Portuguesa de Medicina Geral e Familiar; Vol. 41 Núm. 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-72
Revista Portuguesa de Medicina Geral e Familiar; Vol. 41 N.º 2 (2025): Revista Portuguesa de Medicina Geral e Familiar; 168-72
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