“R/O Lymphoma”: Secondary Skin Involvement by Mantle Cell Lymphoma With Plasmacytic Differentiation

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A 78-year-old man had a skin biopsy submitted to a dermatopathology laboratory with the clinical data of “r/o lymphoma”; as the diagnosis was unclear, it was then sent to a consultant dermatopathologist. Because of a clonal plasmacytoid population, the consultant rendered the diagnosis of marginal zone lymphoma. A subsequent telephone call from the oncologist caring for the patient revealed that there was a long history of mantle cell lymphoma, and additional studies showed that the correct diagnosis was a rare variant, mantle cell lymphoma with plasmacytic differentiation. Biopsies submitted for the diagnosis of lymphoma should include pertinent clinical information, and the failure to do so can lead to added expense and possible misdiagnosis.

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