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10 January 2020 : Case report  Latvia

Diagnostic Challenges and Treatment Options for Cutaneous T Cell Pseudolymphoma: A Case Study with Rituximab Treatment

Mistake in diagnosis, Diagnostic / therapeutic accidents, Rare disease

Dārta Balode12ABEF*, Ludmila Beļajeva2B, Vanessa Ruesseler3BE, Alexander Quaas3B, Sandra Lejniece12ABDE

DOI: 10.12659/AJCR.919616

Am J Case Rep 2020; 21:e919616

Abstract

BACKGROUND: Pseudolymphoma is a rare disorder that can mimic lymphoma both clinically and histologically. It usually affects middle-aged females. Since pseudolymphoma is a rare disorder not only is diagnosing the condition difficult, but there is also a lack of standardized treatment guidelines. In the literature, anti-CD20 monoclonal antibody rituximab is described as an effective treatment option.

CASE REPORT: 46-year-old female fell ill suddenly with swelling and enlargement of her chin. Multiple skin biopsies were done, which were re-evaluated multiple times as well. Each ended with a new diagnosis for the patient. Finally, in the last revision of biopsy material, pseudolymphoma was confirmed. The patient received multiple courses of corticosteroid treatments – locally and systemically – without long lasting effect. After diagnosis of pseudolymphoma, the patient was started on intravenous rituximab and this treatment was effective.

CONCLUSIONS: Cutaneous pseudolymphoma is a diagnostic challenge. Rituximab is a treatment option for refractory pseudolymphoma. Since there are no treatment guidelines for pseudolymphoma, more clinical studies are needed to establish best treatment options for these patients. Therefore, each reported clinical case is important.

Keywords: Genes, T-Cell Receptor, Pathology, Pseudolymphoma, Antibodies, Monoclonal, Biopsy, Chin, Diagnosis, Differential, Diagnostic Errors, Lymphoma, T-Cell, Cutaneous, Middle Aged, Rare Diseases, rituximab, Skin Diseases

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923