Tiger-man appearance in a case of DLBCL

Abstract

Primary cutaneous Epstein–Barr virus‐positive diffuse large B‐cell lymphoma (PC‐EBV‐DLBCL) is a rare and aggressive neoplasm with a poorer prognosis than other cutaneous lymphoma. Here, we present the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan findings of a 39-year-old male with erythematous ulcerative nodules, which showed a gamut of cutaneous lesions consistent with EBV-associated PC‐DLBCL. We highlight the utility of 18F-FDG PET/CT in evaluating the extent of disease, involvement of extranodal sites, and response to treatment in PC‐EBV‐DLBCL. A 39-year-old male presented with erythematous ulcerative nodules which were gradually enlarging reddish and painless cutaneous-subcutaneous masses surrounded with some erythematous patches and ulcers on his back for 1 year. Clinical examination revealed impaired general condition and multiple large ulcerations, the largest measuring 15 cm × 10 cm on the back with no evidence of mucosal lesions or peripheral lymphadenopathies. Further, his blood investigations showed elevated lactate dehydrogenase levels (405 U/L). Histopathological examination of the tissue from the skin lesion revealed atypical lymphoid cells. 18F-FDG PET/CT was done to rule out systemic involvement [Figure 1].