Secondary skin involvement in gastric diffuse large B-cell lymphoma treated with chidamide: A case report

• Published in: Medicine (Baltimore) 2018-12, Vol.97 (49), p.e13093-e13093
• Main Authors: Yang, Dan, Zhang, Wei-Ping, Yang, Jian-Min, He, Miao-Xia, Cheng, Chao, Chen, Jie
• Format: Article
• Language: English
• Subjects: Aminopyridines - therapeutic use; Antineoplastic Agents - therapeutic use; Benzamides - therapeutic use; Clinical Case Report; Diagnosis, Differential; Humans; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - pathology; Male; Middle Aged; Skin Neoplasms - diagnosis; Skin Neoplasms - drug therapy; Skin Neoplasms - secondary; Stomach Neoplasms - diagnosis; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000013093

Diffuse large B-cell lymphoma (DLBCL) is a neoplasm of large B lymphoid cells that exhibits diffuse growth patterns. Patients may present with nodal and/or extranodal disease. The most common extranodal site is the gastrointestinal tract, while skin is less common. We report a case of secondary skin involvement of an original gastric DLBCL, which has achieved a complete response after treatment with chidamide. Initially, the diagnosis of gastric DLBCL is clear, and this patient responded well to systemic chemotherapy (rituximab + cyclophosphamide + epirubicin + vincristine + prednisone) after 8 cycles. Thirty months later, some rapidly enlarging skin nodules on his arm were found. These skin nodules were diagnosed as secondary cutaneous DLBCL based on the clinical features, positron emission tomography-computed tomography, and histomorphologic and immunohistochemical expression. Steroids, interferon-α, and radiation had little therapeutic effect. We treated the patient with chidamide at 30 mg twice per week in combination with dexamethasone. The skin nodules regressed 3 weeks later. During the 1-year follow-up period, the patient is still in treatment with chidamide without adverse reactions. To the best of our knowledge, this is the first case of secondary skin DLBCL reported to exhibit a complete response to chidamide, which provides a novel therapeutic strategy for secondary skin DLBCL. However, more cases are still needed to further validate its efficacy.