Cutaneous Large B Cell Lymphoma Involving the Duodenum and the Bile Duct: a Case Report

  • Lamine Hamzaoui
  • Mouna Medhioub
  • Amal Khsiba
  • Moufida Mahmoudi
  • Talel Badri
  • Mohamed Msaddak Azouz
Case Report


Primary cutaneous B cell lymphoma (PCBCL), leg type, is a rare and aggressive neoplasm [1, 2]. Primary or secondary bile duct obstruction is considered a poor prognostic sign for non-Hodgkin’s lymphoma [3]. We present a case of a 63-year-old man, with a BCBCL, leg type, on his back, disseminated to the duodenum and the common bile duct.

Case Report

A 63-year-old male patient presented a huge indolent tumor (60 cm in diameter), with peripheral annular erythematous and pigmented reinforcement on the back next to the left shoulder, evolving for 1 year and ignored by the patient (Fig.  1). A skin biopsy was performed 3 months before admission and histologic examination showed dense diffuse lymphocytic infiltrate of centroblasts and immunoblasts. An immunohistochemical analysis showed positivity of CD20 and Bcl-2 and negativity of the other markers: MUM-1, and Bcl-6, CD30, and Epstein-Barr virus stains including Epstein-Barr encoded RNA. A primary cutaneous B cell lymphoma...



primary cutaneous B cell lymphoma


Epstein-Barr virus


Epstein-Barr encoded RNA


alkaline phosphatase




aspartate amino transferase


alanine transferase


prothrombin time

CA 19-9

Cancer antigen 19-9


human immunodeficiency virus


magnetic resonance cholangiopancreatography

CT scan

computed tomography scan


common bile duct


endoscopic retrograde cholangiopancreatography


rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone


Compliance with Ethical Standards

Informed Consent

Informed consent was not obtained because the patient died and we have no contact of his relatives (unreachable by phone and other methods).

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Huang CT, Yang WC, Liu YC, Lin SF. Primary cutaneous diff use large B-cell lymphoma, leg type, with unusual clinical presentation of bluish reddish multicolored rainbow pattern. J Clin Oncol. 2011;29(17):e497–8.CrossRefPubMedGoogle Scholar
  2. 2.
    Senff NJ, Noordijk EM, Kim YH, Bagot M, Berti E, Cerroni L, et al. European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas. Blood. 2008;112(5):1600–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Feller E, Schiffman FJ. Extrahepatic biliary obstruction by lymphoma. Arch Surg. 1990;125(11):1507–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Thomas V, Dobson R, Mennel R. Primary cutaneous large B-cell lymphoma, leg type. Proc (Bayl Univ Med Cent). 2011;24(4):350–3.CrossRefGoogle Scholar
  5. 5.
    Yalçin S, Kars A, Sökmensüer C, Atahan L. Extrahepatic Hodgkin’s disease with intrahepatic cholestasis: report of two cases. Oncology. 1999;57(1):83–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Di Sena V, Thuler FP, Macedo EP, Paulo GA, Della Libera E, Ferrari AP. Obstructive jaundice secondary to bile duct involvement with Hodgkin’s disease: a case report. Sao Paulo Med J. 2005;123(1):30–2.CrossRefPubMedGoogle Scholar
  7. 7.
    Joo YE, Park CH, Lee WS, Kim HS, Choi SK, Cho CK, et al. Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice. J Gastroenterol. 2004;39:692–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Senff NJ, Hoefnagel JJ, Neelis KJ, Vermeer MH, Noordijk EM, Willemze R. Dutch cutaneous lymphoma group. Results of radiotherapy in 153 primary cutaneous B-cell lymphomas classified according to the WHOEORTC classification. Arch Dermatol. 2007;143(12):1520–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Lamine Hamzaoui
    • 1
    • 2
  • Mouna Medhioub
    • 1
    • 2
  • Amal Khsiba
    • 1
    • 2
  • Moufida Mahmoudi
    • 1
    • 2
  • Talel Badri
    • 2
    • 3
  • Mohamed Msaddak Azouz
    • 1
    • 2
  1. 1.Gastroenterology DepartmentMohamed Tahar Maamouri HospitalNabeulTunisia
  2. 2.Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
  3. 3.Dermatology DepartmentHabib Thameur HospitalTunisTunisia

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