Primary cutaneous high-grade centrofollicular B-cell lymphoma: A case of complete response achieved with precise 3D conformal radiotherapy

Primary cutaneous high-grade centrofollicular B-cell lymphoma, in its localized form, represents a rare entity requiring a therapeutic strategy that optimizes local control while minimizing toxicity. This is illustrated by the case of a 43-year-old male with a tumor lesion on the upper back, progressively evolving over 7 months. Biopsy confirmed a high-grade centrofollicular B-cell lymphoma (Ki-67 >70%), staged as T2aN0M0 following extension work-up. The chosen treatment was definitive, curative-intent three-dimensional conformal radiotherapy (3D-CRT), delivering a total dose of 40 Gy in 20 fractions, planned meticulously to achieve an optimized dose distribution. Treatment tolerance was excellent, limited to a grade 1 radiation dermatitis. The 3-month evaluation revealed a complete clinical and radiological remission with sustained locoregional control. This case demonstrates that this conventional yet precisely applied technique, through rigorous target volume delineation and an adapted prescription, provides a robust and accessible therapeutic option, achieving optimal tumor control with minimal toxicity in these localized aggressive cutaneous B-cell lymphomas. Categories: Radiation Oncology, Oncology, Dermatology