[T-cell-rich B-cell lymphoma. Presentation of 3 cases]. / Linfoma B rico en células T. Presentación de tres casos.

T-cell-rich B-cell lymphoma (TBL) is a rare entity not included in the classical classifications of non-Hodgkin's lymphomas (NHL), presenting usually at diagnosis in advanced stages and with extranodal involvement. Its differential diagnosis, based on immunophenotyping technics, include other entities with different treatment and prognosis, mainly lymphocytic-predominance Hodgkin disease and peripheral T-cell lymphoma; this differential diagnosis has importance in patient's survival. We present 3 patients, two males (one of them with HIV infection) and one female, aged 38, 60 and 64 respectively, diagnosed as having TBL. The two former patients presented advanced stages at diagnosis. None of them was initially diagnosed as having TBL, the diagnosis were immunoblastic NHL in the first patient, peripheral T-cell lymphoma in the second and mixed cellularity Hodgkin's disease in the third one. The first patient was not treated due to rapid worsening and early death of septic shock; the other two cases were treated with COP-BLAM/IMVP-16 protocol achieving partial and complete remission respectively after 6 cycles of treatment. Comments about clinical, pathological and differential diagnostic aspects are made.

[Patient with Hansen disease and lepromatous reaction with predominant neural involvement]. / Paciente con enfermedad de Hansen y reacción lepromatosa con afectación neural predominante.

We describe a patient with a diagnosis of Hansen's disease borderline type, presenting as cutaneous lesions and silent multineuritis. Samples of nasal mucus, earlobe and cutaneous lesions were positive for acid-fast bacilli. He was given treatment with rifampin, dapsone and clofazimine. Five years later, he developed fever, poliarthritis, orchitis and hepatic involvement. Searching for acid-fast bacilli in many cutaneous and mucosal locations was fruitfulness. Because of clinical suspicion of erythema nodosum leprosum, he was treated with steroids with improvement of his clinical picture, but subsequently he developed multineuritis with many sensitive symptoms. A high number of bacilli was seen in nerve biopsy. We comment on atypical features of clinical evolution and erythema nodosum leprosum, and emphasize the significance of large number of bacilli into peripheral nerve in contrast with their absence at other levels.