A 74-year-old male patient with a history of hypertension was treated.
It was characterized by multiple skin lesions of the trunk of 15 days of evolution.
Clinical examination revealed multiple erythematous-violaceous, non-painful and pruritic plaques and nodules, ranging between 0.3 and 5 cm, located mainly on the trunk.
No lymphadenopathy or visceromegaly were found.
Blood count showed leukopenia (leucocytes: 3,600/mm liver function tests: 46% hemoglobin: 1.1%, eosinophils: 2.1%, neutrophils: 56.9%, lymphocytes: 33.2%, monocytes: 6.7%),
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The anatomopathological study of the lesions showed a fragment of skin with dense dermal-hypoderm nodular infiltrate, composed of medium-sized cells and immature aspect, with irregular nuclei, concise nuclei.
No epidermotropism, necrosis or angioinvasion were observed.
Immunohistochemistry was positive for CD56, CD4, CD 123, CD45, CD43, and TdT; while CD3, CD45RO, CD20, CD79a, CD5, CD117 and MPO were negative
Clinical and histopathological findings were conclusive with a DPNB.
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The staging study with computed tomography (CT) of neck, chest and abdomen showed peritracheal and carinal adenopathies up to 1.2 cm. There was no evidence of bone marrow involvement in the iliac crest biopsy.
Currently, after 5 months, the patient is in the fourth cycle of cyclophosphamide-doxorubicin-vincristine-prednisone (CHOP) with partial regression of skin lesions.
