Malignant lymphoma and leukemia with prominent ulceration: Clinicopathologic correlation of 33 cases

Background: The clinical and pathologic findings in patients with malignant lymphomas who presented with prominent cutaneous ulcers are described. Objective: Our purpose was to determine the histologic findings, type, and prognosis of lymphomas with cutaneous ulcers. Methods: Thirty-three patients (20 with cutaneous T-cell lymphomas, 10 with other non-Hodgkin's lymphomas, and 3 with leukemia) were retrospectively studied. Results: All patients had a poor prognosis; 23 died within 9 months after the onset of the ulcers. Patients with non-Hodgkin's lymphoma had a worse prognosis, had a higher incidence of systemic involvement, and more often had ulcers as an initial manifestation of lymphoma than did the patients with cutaneous T-cell lymphoma. The histopathologic findings ranged from a nonspecific inflammatory infiltrate to ulcers with marked adjacent epidermal epider-motropism to ulcers with an angiocentric infiltrate. Conclusion: A variety of lymphomas may cause cutaneous ulceration. Adequate sampling of these ulcers is necessary for diagnosis. The average life expectancy after ulcer formation is 21 months.