Precursor B-cell lymphoblastic lymphoma involving the skin

Precursor B-cell lymphoblastic lymphoma (B-LBL) is a rare neoplasm composed of immature lymphocytes that demonstrate lymphoblastic morphology and express precursor and B-cell marker. It usually affects people of younger age group and causes multiple nodules on the head and neck area. The neoplasm is rare in old age. We report a case of B-LBL occurring in a 65-year-old man. He presented with multiple skin nodules on the scalp, the neck and the arm for 2 months. Histopathologic examination demonstrated diffuse dermal and subcutaneous monotonous infiltrates of medium-sized lymphoid cells with starry-sky pattern. Immunohistochemical study showed that the lymphoid cells of infiltrate showed precursor B-cell type. The patient has received combination chemotherapy three times and is being followed-up at the outpatient clinic.