血管内大B细胞淋巴瘤一例

患者,女,82岁。大腿、腹部皮疹2月余,伴间歇性发热。体检：浅表淋巴结未扪及肿大,肝脾肋下未触及。神经系统检查未见异常。双股及下腹部可见大小不一的暗红色斑块,质地坚实,有触痛,伴有明显的非凹陷性水肿,皮肤表面高低不平,局部呈橘皮样外观。血常规示三系减低。乳酸脱氢酶显著升高。第1次大腿部肿块穿刺和病理活检均未明确诊断。在不同医院诊断过慢性淋巴管炎、皮肤变应性血管炎和发热待查,经抗生素治疗无效,皮疹从大腿渐扩展至下腹部。第2次皮肤组织病理：皮下脂肪组织间隔血管腔内可见异形淋巴样细胞。免疫组化：异形淋巴样细胞抗淋巴细胞毒抗体（LCA）、CD20、CD79α、bcl-2阳性,bcl-6、CD10、CD3、CD45RO、CD30、EMA、AE1/3、CK均阴性,血管内皮细胞示CD34阳性。基于其组织形态学表现,结合免疫组化标记结果,符合血管内大B细胞淋巴瘤的诊断。患者2个月后死亡。     

血管内大B细胞淋巴瘤

报告1例血管内大B细胞淋巴瘤。患者女,63岁。双下肢多发红斑、皮下结节半年余。组织病理显示真皮及皮下脂肪小到中等大血管内可见大量的形态大小较为一致的肿瘤细胞,瘤细胞体积较大。免疫组化结果显示血管内肿瘤细胞CD20、CD79a、B细胞淋巴瘤-2基因(BCL-2)、BCL-6、多发性骨髓瘤癌基因1(MUM1)阳性,CD2、CD3、CD4、CD8、CD30、CD56、穿孔素、颗粒酶、T细胞内抗原(TIA)阴性,Ki-67增殖指数100%,EBV原位杂交阴性。诊断为血管内大B细胞淋巴瘤。     

皮下血管内大B细胞淋巴瘤

报告1例皮下血管内大B细胞淋巴瘤.患者男,73岁.因双侧大腿皮下结节,于2007年2月初就诊.皮损组织病理检查见血管腔内有大量肿瘤细胞聚集,免疫组化染色结果示肿瘤细胞CD20阳性,诊断为皮下血管内大B细胞淋巴瘤(IVLBCL).予环磷酰胺、长春新碱、泼尼松(COP方案)化疗后皮损缩小.IVLBCL恶性程度较高,临床表现无特异性,预后较差,皮损组织病理检查有助于诊断.     

血管内大B细胞淋巴瘤一例

患者女,60岁。反复双下肢结节、溃疡、坏死1年,加重6个月。患者1年前,出现左下肢结节、溃疡、坏死,皮肤瘢痕、硬化,皮损沿血管走行,伴有间断发热。2012年8月16日皮损组织病理检查提示皮肤血管炎,给予甲泼尼龙80 mg/d治疗15 d,皮损好转,但糖皮质激素减量后病情出现反复。既往有慢性肾功能不全病史7年,贫血病史2年及甲状腺结节病史1年……     

皮肤血管内T细胞淋巴瘤:1例报道及文献复习

对1例血管内淋巴瘤进行免疫表型分析及原位杂交检测与 EB病毒的关系,并复习相关文献患者男,32岁,发热2个月,左大腿斑块1月.全身体检及辅助检查血小板90× 109,血沉24mm/h,C反应蛋白28.9 mg/L,LDH 448 U/L.病理学检查肿瘤细胞位于真皮层的小血管内,瘤细胞体积较大、核仁明显、胞浆嗜碱性,核分裂相可见.瘤细胞免疫表型CD3,CD45( LCA)呈阳性表达.原位杂交显示E2BERs阴性.患者经CHOP联合化疗一个疗程后获得缓解.血管内T细胞淋巴瘤是一种罕见淋巴瘤,此瘤的诊断必须依赖病理学及免疫组织化学检查,在不明原因发热伴发皮肤斑块时,应及时活检,积极联合化疗.     

原发性皮肤弥漫大B细胞淋巴瘤1例

患者男，70岁．因右踝伸侧、右股内侧及左小腿内侧出现半球形皮肤肿物3个月余，于2006年5月20日来我院就诊.患者3个月前无明显诱因右踝伸侧出现皮下结节，逐渐增大至鸡卵大，表面破溃，出现卫星状结节。2个月前有股内侧及左下肢出现类似肿块，分别为鸡蛋和鸽蛋大，无明照自觉症状，未于正规治疗，肿物渐增大。否认有外伤史，家族无类似疾病史。[第一段]     

皮肤弥漫大B细胞淋巴瘤1例

我科于2013年9月16日收治1例皮肤弥漫大B细胞淋巴瘤-腿型患者,现报告如下。1病历摘要患者女,68岁。因左小腿内侧红色包块伴疼痛3个月余于2013年9月16日就诊。患者自述3个月前无明显诱因自觉左小腿内侧中上段出现疼痛不适,于局部触及约3 cm×2 cm梭形疼痛性皮下包块,表面皮肤正常,四五天后于该部位皮肤表面出现一2 cm×4 cm红色斑块,未予重视,约2周后于该包块下方约5 cm处出现类     

A case report and literature review of cutaneous intravascular large B-cell lymphoma presenting clinically as panniculitis: a difficult diagnosis,but a good prognosis

Intravascular large B-cell lymphoma is a rare, non-mass-forming, extranodal large B-cell lymphoma subtype characterized by the presence of tumor cells in the lumens of vessels. It is divided into two major types: classical and Asian. Patients presenting only with skin involvement are mostly female, at a younger age than classical intravascular large B-cell lymphoma patients, and have a better prognosis. Since the diagnosis of cases with isolated skin involvement is difficult, keeping this entity in mind, performing a careful microscopic examination, and applying new, effective treatment regimens will make it possible to achieve better clinical outcomes in these cases.     

Concurrent mycosis fungoides and intravascular large B-cell lymphoma in a single patient

Mycosis fungoides (MF) is an indolent, uncommon, non-Hodgkin T-cell lymphoma of the skin. It classically presents with patches, plaques, and tumors and may rarely show spread to internal organs or bone marrow. Up to 7.5% of MF patients may be diagnosed with a second malignancy. Intravascular large B-cell lymphoma (IVLBCL) is an exceedingly rare non-Hodgkin B-cell lymphoma characterized by predominant growth of large neoplastic cells in the lumina of blood vessels. This case presents with an unusual confluence of two rare diagnoses, MF and IVLBCL, made more remarkable by the presence of both diagnoses on a single skin biopsy sample.     

原发于皮肤的老年人EB病毒阳性弥漫大B细胞淋巴瘤一例

患者男,88岁。双下肢多发结节、溃疡6个月。皮肤科检查：双下肢多个暗紫色结节,触之较硬,中央溃疡、结痂。组织病理检查：真皮内及皮下组织淋巴样细胞弥漫浸润,细胞核大、深染,异形性明显,可见核分裂象,部分区域可见小灶状坏死。大淋巴样细胞表达CD20、CD79a、Bcl?2,EB病毒编码RNA原位杂交阳性。诊断：EB病毒阳性弥漫大B细胞淋巴瘤。患者放弃系统化疗,确诊6个月后死亡。     

原发性皮肤弥漫性大B细胞淋巴瘤一例

患者,男,51岁。左小腿红斑、结节、斑块伴疼痛3个月。组织病理及免疫组化确诊为原发性皮肤弥漫性大B细胞淋巴瘤,腿型。     

原发性皮肤弥漫大B细胞淋巴瘤（腿型）一例

报告1例原发性皮肤弥漫性大B细胞淋巴瘤（腿型）。患者男,51岁。右小腿出现多个红色结节5个月,组织病理检查：表皮和真皮之间见无细胞浸润带,真皮内淋巴样细胞浸润,细胞体积大,异形。肿瘤细胞CD20（++）,Bcl-6(+),Bcl-2(+),Pax-5(+),Ki-67 50％-75％(+),CD79a(+),MUM-1（+）,CD10（-）,诊断为原发性皮肤弥漫性大B细胞淋巴瘤（腿型）,给予CD20单克隆抗体加CHOP方案治疗,病情好转。     

Comparative genomic hybridization analysis of cutaneous large B-cell lymphomas

The aim of the present study was to identify genetic aberrations in a series of patients with cutaneous large B-cell lymphoma (LBCL) using comparative genomic hybridization (CGH). Eighteen consecutive patients with primary (13 patients) (PCLBCL) and secondary (five patients) (SCLBCL) cutaneous large B-cell lymphoma were included in the study. Nine cases corresponded to PCLBCL leg type and four cases primary cutaneous follicle centre-cell lymphoma (PCFCL). Chromosomal imbalances (CIs) were detected in 14 of 18 samples (77.8%). All of nine cases with PCLBCL leg type and two of four cases with PCFCL showed CIs (100% and 50%, respectively). Regarding SCLBCL, in three of five cases (60%), CIs were detected. The most frequently detected gains involved 2q, 5q, 3 and 7q and amplifications affected 18, 12 and 13. Frequent losses were found in 17p. In PCLBCL leg type, the most frequent gains involved 2q and 7q, amplifications were localized in chromosomes 12, 13 and 18 and losses affected chromosomes 17p and 19. In PCFCL, gains located in 3q, 4 and 7q were found. Our study seems to confirm clear-cut differences between primary cutaneous LBCL and nodal diffuse LBCL, and it suggests the presence of genotypic differences between cases of PCLBCL leg type and cases of PCFCL.     

原发性皮肤弥漫大B细胞淋巴瘤,腿型

报告1例原发性皮肤弥漫性大B细胞淋巴瘤（腿型）。患者女,82岁。左小腿出现3个红色结节2个月,组织病理检查发现真皮内淋巴样细胞浸润,无嗜表皮现象,细胞体积大,肿瘤细胞CD20（＋）,CD79α（＋）,Bcl-2（＋）,Bcl-6（＋）,Ki-67 70％（＋）,MUM-1（＋）,Pax-5（＋）,CD10（-）,诊断为原发性皮肤弥漫性大B细胞淋巴瘤（腿型）,全身检查未发现皮肤以外系统受累证据,行局部肿瘤切除及口服糖皮质激素治疗。