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。     

原发性皮肤弥漫性大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,77岁.因右胫前多发暗红色斑块和结节3个月入院.皮损组织病理检查示:肿瘤细胞在真皮内弥漫性浸润性生长,侵及皮下组织,肿瘤细胞体积增大,形态不规则,细胞核大深染,核分裂象多见.免疫组化染色示:瘤细胞CD20(+),CD79a(+),Bcl-2(+),MuM-1(+).诊断:原发性皮肤弥漫性大B细胞淋巴瘤,腿型.通过CD20单克隆抗体加CHOP化疗方案治疗,病情明显好转.     

原发性皮肤弥漫性大B细胞淋巴瘤（腿型）二例并文献复习

弥漫性大B细胞淋巴瘤（腿型）是皮肤B细胞淋巴瘤的一个罕见亚型，具有特征性的临床、病理、免疫组化及演变特征。本文报道2例原发性皮肤弥漫性大B细胞淋巴瘤（腿型）并复习相关文献。     

原发性皮肤弥漫大B细胞淋巴瘤1例

报告1例原发性皮肤弥漫大B细胞淋巴瘤。患者男,72岁,因四肢、躯干红斑、结节、肿块2年,加重伴溃烂3月,于2009年3月9日就诊。皮损组织病理检查报告见皮肤真皮内大量淋巴样细胞弥漫浸润,未侵及表皮,免疫组化染色结果示瘤细胞L26（＋）,Bcl-6（＋）,Mum-1（＋）,CD10弱（＋）,K i-67（＋）约90%。诊断为原发性皮肤弥漫性大B细胞淋巴瘤。     

原发性皮肤弥漫大B细胞淋巴瘤(腿型)3例

 报道3例原发性皮肤弥漫大B细胞淋巴瘤(腿型)。患者2女1男,年龄分别为77、57和77岁,分别表现为下肢、上肢及背部单发的无痛性肿块。皮损组织病理表现为真皮弥漫浸润的肿瘤细胞,体积大,异型性明显;免疫组化显示肿瘤细胞表达CD79a及Mum-1,而Bcl-6及Bcl-2呈阳性或阴性。诊断为原发性皮肤弥漫大B细胞淋巴瘤(腿型)。3例患者经过利妥昔单抗联合化疗后临床症状完全缓解,其中1例发生皮肤外扩散。     

第三讲原发性皮肤大细胞淋巴瘤的分类

原发性皮肤大细胞淋巴瘤（PCLC）可分为T细胞性和B细胞性两类。T细胞表型PCLCL[PCLCL(T)]可以CD30阳性与否预期其预后。CD30^＋PCLCL(T)和CD30^ 非皮肤原发性LCL（T）的预后差。从蕈样肉芽肿转化成的CD30^ 皮肤LCL的预后一般差，从淋巴瘤样丘疹病演变成的CD30^ -LCL仅系统性的预后差而皮肤CD30^ -LCL的预后则不差。原发性皮肤多形T细胞性淋巴瘤，大细胞型和原发性皮肤T－免疫母细胞性淋巴瘤的预后差。B细胞表型原发性皮肤大细胞淋巴瘤中绝大多数为原发性皮肤滤泡中心细胞性淋巴瘤，其预后较淋巴结滤泡中心细胞性淋巴瘤为好。     

面部原发性皮肤弥漫性大B细胞淋巴瘤-腿型一例

82岁女性患者,面部红色结节1个月余。结节组织病理示真皮内淋巴样肿瘤细胞浸润,无嗜表皮现象,细胞体积大,CD20、PAX5、CD79a、BCL-2、MUM1均阳性,Ki-67 90%阳性,BCL6、CD10阴性。诊断:面部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,治疗行局部肿瘤切除及化疗。     

原发性皮肤弥漫性大B细胞淋巴瘤(腿型)一例

正原发性皮肤弥漫性大B细胞淋巴瘤(腿型)多见于老年女性患者,占原发性皮肤淋巴瘤的2%~4%,预后不良,临床极易误诊,现将临床误诊为皮肤结节病的原发性皮肤弥漫大B细胞淋巴瘤(腿型)1例报告如下。临床资料患者,女,68岁。主因左小腿内侧红色肿块伴疼痛3个月余,于2013年9月就诊。3个月前,无明显诱因患者左小腿胫侧皮下可触及3 cm×2 cm大     

原发性皮肤弥漫性大B细胞淋巴瘤

报告1例原发性皮肤弥漫性大B细胞淋巴瘤.患者男,87岁.右下肢结节1年余.皮肤科检查:右下肢内侧可见8 cm×8 cm肿块,周围可见数个大小不等黄豆至蚕豆大的散在褐色结节.皮损组织病理示:表皮萎缩,真皮内可见单一核细胞呈团块状浸润,细胞体积大,胞质丰富,胞核淡染,并见核异形性和较多核分裂象.免疫组化结果:Bcl-2(+)、MUM-1(+).诊断:原发性皮肤弥漫性大B细胞淋巴瘤(腿型)(PCLBCL-LT).     

原发性皮肤弥漫性大B细胞淋巴瘤(腿型)2例报道伴文献复习

目的:通过探讨原发性皮肤弥漫性大B细胞淋巴瘤临床表现和病理特点,提高对该病的认识,实现早诊早治。方法:对2例疑似原发性弥漫性大B淋巴细胞瘤(腿型)患者进行临床表现分析及组织病理检查,通过检测细胞表面抗原标记确诊,采用利妥昔单抗联合CHOP方案化疗,21天为1个疗程,连续半年结束疗程继续随访。结果:弥漫性大B淋巴细胞瘤进展迅速,可破溃,组织病理检查表现为真皮单核细胞浸润,细胞异型明显,免疫组化表现为B细胞表型,CD20(+),CD79a(+),BCL-2(+),CD10(-),BCL-6(-),采用利妥昔单抗联合CHOP方案治疗,随访2年疗效肯定。结论:利妥昔单抗联合CHOP方案化疗连续6个疗程治疗原发性弥漫性大B细胞淋巴瘤,效果肯定。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.