Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options

Changjun Chen; Meng Si; Xianlei Gao; Wenhan Wang; Songgang Wang; Xin Pan

doi:10.5114/ada.2021.108444

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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abstract:

Original paper

Primary cutaneous diffuse large B-cell lymphoma after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options

Changjun Chen

^{1, 2}

,

Meng Si

¹

,

Xianlei Gao

¹

,

Wenhan Wang

¹

,

Songgang Wang

¹

,

Xin Pan

¹

Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, China
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China

Adv Dermatol Allergol 2022; XXXIX (3): 545-552

DOI: https://doi.org/10.5114/ada.2021.108444

Online publish date: 2021/08/16

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AMA

Chen C, Si M, Gao X, Wang W, Wang S, Pan X. Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(3):545-552. doi:10.5114/ada.2021.108444.

APA

Chen, C., Si, M., Gao, X., Wang, W., Wang, S.,  & Pan, X. (2022). Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(3), 545-552. https://doi.org/10.5114/ada.2021.108444

Chicago

Chen, Changjun, Meng Si, Xianlei Gao, Wenhan Wang, Songgang Wang,  and Xin Pan. 2022. "Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 39 (3): 545-552. doi:10.5114/ada.2021.108444.

Harvard

Chen, C., Si, M., Gao, X., Wang, W., Wang, S.,  and Pan, X. (2022). Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(3), pp.545-552. https://doi.org/10.5114/ada.2021.108444

MLA

Chen, Changjun et al. "Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 39, no. 3, 2022, pp. 545-552. doi:10.5114/ada.2021.108444.

Vancouver

Chen C, Si M, Gao X, Wang W, Wang S, Pan X. Primary cutaneous diffuse large B-cell lymphoma
after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(3):545-552. doi:10.5114/ada.2021.108444.

Introduction
Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL) after total knee arthroplasty (TKA) is rare. Aim: The literature that analyses the cutaneous manifestations of PCDLBCL and assesses the effect and the outcome of treatment is scarce.

Material and methods
We described a case of PCDLBCL after TKA, whose cutaneous mass develops around surgical sites, mimicking a prosthetic joint infection. In addition, we conducted a systematic review of 29 reported cases with PCDLBCL. Primary endpoint for the review was main cutaneous manifestations of PCDLBCL. Secondary endpoint included treatment options of PCDLBCL and optimal therapeutic method.

Results
We found that the main cutaneous manifestations include infiltrative cutaneous lesions such as macules, papules or nodules, some of them presented as ulcerations or formation of vesicles, subcutaneous nodules or both. The treatment options include excision, radiotherapy, chemotherapy, and even “watchful waiting” as spontaneous regression was noted in some cases. Systemic chemotherapy is the most frequent initial treatment approach chosen, of which rituximab is often combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy and patients who received systemic rituximab tend to have a better overall survival (OS) time than those who did not.

Conclusions
PCDLBCL is a rare disease after TKA, however, an early recognition and distinguishing from infection is still needed. Patients with PCDLBCL may profit from rituximab-based chemotherapy, increasing the survival rate, despite the high relapse rate and limited OS time in some cases.

keywords:

Primary cutaneous diffuse large B-cell lymphoma after total knee arthroplasty: a case study and a systematic review of its cutaneous manifestations and treatment options

Changjun Chen 1, 2 , Meng Si 1 , Xianlei Gao 1 , Wenhan Wang 1 , Songgang Wang 1 , Xin Pan 1

primary cutaneous diffuse large B-cell lymphoma, arthroplasty, cutaneous manifestations, treatment

Changjun Chen

^{1, 2}

,

Meng Si

¹

,

Xianlei Gao

¹

,

Wenhan Wang

¹

,

Songgang Wang

¹

,

Xin Pan

¹