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Kjell Matthias Kaune, MD; Mario Baumgart, MSc; Stefan Gesk, MD; Peter Middel, MD; B. Michael Ghadimi, MD; Reiner Siebert, MD; Hans Peter Bertsch, MD; Michael Peter Schön, MD; Christine Neumann, MD

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Report of a Case

A 62-year-old man presented with mucosa-associated lymphoid tissue (MALT) lymphoma manifesting primarily in the oropharyngeal mucosa, bone marrow, and peripheral blood and consequently manifesting a distinct type of secondary skin involvement. At diagnosis, the malignant bone marrow cells showed no chromosomal translocations (including MYC break points) as evidenced by fluorescence in situ hybridization analysis (FISH). Three months later, and 1 week after receiving therapy with rituximab, the patient developed a purpuric exanthema resembling allergic vasculitis (Figure 1A and B). Moreover, his upper arms displayed bluish livedolike lesions (Figure 1C and D). Biopsy specimens from both types of lesions revealed infiltrates of monomorphic lymphoplasmacytoid tumor cells (CD20⁺, CD79a⁺, Bcl-2⁺, ⁺, CD5^–, CD23^–. . . [Full Text of this Article]

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