Cutaneous manifestations of B-CLL masked by florid epithelioid granulomatous response

We report an unusual case of iterative cutaneous manifestations of B-cell c hronic lymphocytic leukaemia, masked by a florid epithelioid granulomatous response. These cutaneous lesions appeared without blood hyperlymphocytosis or lymph node enlargement. The diagnosis of cutaneous tumorous infiltrates was morphologically very difficult and required immunohistochemistry as we ll as PCR. This observation stresses the diagnostic difficulties encountere d in lymphoma. with intense stroma reaction and the need for complementary techniques to reach the right diagnosis and thus deliver appropriate therap y.