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Disseminated Mantle-Cell Lymphoma Presenting as a Petechial Maculopapular Eruption

Sarah I. Jawed, BA1; Travis J. Hollmann, MD, PhD2; Craig H. Moskowitz, MD3; Garrett Desman, MD4; Christiane Querfeld, MD, PhD1
[+] Author Affiliations
1Department of Medicine, Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York
2Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York
3Department of Medicine, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York
4Department of Pathology, Weill Cornell Medical College, New York, New York
JAMA Dermatol. 2014;150(1):94-96. doi:10.1001/jamadermatol.2013.5388.
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Cutaneous involvement by mantle-cell lymphoma (MCL) is rare. We describe an unusual case of advanced-stage MCL that presented with a diffuse petechial maculopapular eruption mimicking a hypersensitivity reaction.

Article InformationCorresponding Author: Christiane Querfeld, MD, PhD, Dermatology Service, Memorial Sloan-Kettering Cancer Center, 160 E 53rd St, New York, NY 10022 (querfelc@mskcc.org).

Published Online: November 20, 2013. doi:10.1001/jamadermatol.2013.5388.

Conflict of Interest Disclosures: None reported.

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Figure.
Patient With Cutaneous Involvement by Mantle-Cell Lymphoma

A and B, Clinically, a diffuse petechial maculopapular eruption is seen on the trunk (A) and thigh (B). C and D, Histologic sections show a superficial to deep dermal perivascular infiltrate (C) (hematoxylin-eosin, original magnification ×20) with areas of red blood cell extravasation (D) (hematoxylin-eosin, original magnification ×200). E, The infiltrate is composed of small to medium-sized lymphocytes with irregular nuclei, condensed chromatin, and inconspicuous nucleoli (E) (hematoxylin-eosin, original magnification ×400). F and G, The atypical lymphocytes are uniformly positive for CD20 (F) (original magnification ×400) and cyclin-D1 (G) (original magnification ×400). H, L-selectin is also expressed by the lymphoma (original magnification ×400).

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