皮肤原发性CD30阳性间变性大细胞淋巴瘤

目的 探讨皮肤原发性CD30阳性间变性大细胞淋巴瘤（ALCL）的临床及组织病理学特征,为病理诊断和鉴别诊断提供依据。方法 采用组织病理学及免疫组织化学SP法的白细胞共同抗原、CD20、CD30、CD45RO、CD68、上皮膜抗原、细胞角蛋白和HMB45染色对9例皮肤原发性CD30阳性ALCL进行观察。结果 患者年龄31-84岁（平均58.2岁）,男女之比2：1,均以皮肤丘疹或皮下包块就诊。组织形态;瘤细胞体积大,呈多形性、圆形或椭圆形,胞质丰富。核大,核仁明显,核分型象多,常见R-S样细胞和多核巨细胞,CD30阳性,其中6例同时表达CD45RO,非T非B型3例表达,随访：2例因肿瘤转移而死亡,2例肿瘤复发,5例无复发,健在。结论 皮肤原发性CD30阳性ALCL是具有独特形态特点及预后较好的肿瘤,根组织病理特征及CD30阳性,可与其他恶性肿瘤鉴别。

Primary cutaneous CD30-positive anaplastic large cell lymphoma

Objective To analyse the clinical manifestations, pathoogical and immunohistochemical features of 9 cases of primary cutaneous CD30 positive anaplastic large cell lymphoma (ALCL) in order to improve the criteria for its early and differential diagnosis. Methods Histopathological method was used to study the morphological characteristics. Immunohistochemical stainings (SP or ABC method) for leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelium membrane antigen (EMA), cytokeratin (CK) and HMB45 were applied to the routine paraffin sections of all the 9 cases. Results The 9 cases of primary cutaneous CD30 positive ALCL consisting of 6 males and 3 females, aged 31 to 84 years (mean 58.2 years). All patients presented with subcutaneous masses or papular eruptions on lower trunk and extremities. Histopatholoically, the lesions were composed of numerous large round, oval or pleomorphic cells with abundant cytoplasm, amphophilic or basophilic, and large nucleus with distinct nucleolus. Mitosis was often observed. Multinucleated giant cells and Reed Sternberg cells may be seen. The neoplastic cells displayed positive antigen markers for CD30 in 9 cases, 6 positive for CD45RO and 3 cases negative for both CD45RO and CD20. Two patients died of metastasis, 2 patients experienced recurrence and 5 patients still well during follow up. Conclusions Primary cutaneous CD30 positive ALCL is a morphologically distinctive neoplasm with a comparatively favorable prognosis. This tumor can be differentiated from other malignant tumors on the basis of histopathologic features and positive CD30 which is of significance.