Lymphomas with predominant spindle-cell morphology have only been previously reported in small numbers; such lesions are potentially mistaken for sarcoma or other spindle-cell tumours. We describe a 73-year-old woman who presented with a tumour on the scalp of a few months’ duration. Biopsy showed a B-cell lymphoma of follicle centre cell origin with a sarcomatoid appearance and a CD20+, CD10+, CD21+, bcl-6+ immunophenotype. This case highlights the very rare occurrence of spindle-cell B-cell lymphoma presenting in the skin. An awareness of this phenomenon is essential to avoid confusion with a variety of other cutaneous spindle-cell neoplasms and to enable a correct diagnosis to be made, thereby ensuring that appropriate treatment is initiated.