原发性皮肤间变性大细胞淋巴瘤

报告1例原发性皮肤间变性大细胞淋巴瘤.患者男,80岁.因右小腿丘疹、结节伴瘙痒2个月就诊.体格检查发现右小腿胫前数十个孤立的丘疹、结节.皮损组织病理检查示真皮全层大细胞弥漫浸润,细胞核呈间变性;免疫组化染色示CD30(+),间变性淋巴瘤激酶(ALK-1)(-).结合临床,诊断为原发性皮肤间变性大细胞淋巴瘤.     

皮肤原发间变大细胞淋巴瘤一例

患者,男,75岁。因躯干及四肢泛发红斑水疱伴瘙痒半年,加重伴双下肢多处溃疡2^＋月入院。患者发病半年前因外伤双下肢出现红斑丘疹水疱,破溃后流黄水,形成糜烂面,逐渐发展至躯干及双上肢,部分红斑丘疹上覆蛎壳状鳞屑,溃疡面上覆黑色坏死样痂皮,就诊于成都多家医院。诊断为＂银屑病＂,治疗效果不佳。患者双下肢水肿明显,溃疡处分泌物增多,故来我院就诊。患者自觉瘙痒疼痛。既往史：有高血压、糖尿病、冠心病。对＂磺胺类药物＂过敏。     

原发性皮肤CD30~+间变性大细胞淋巴瘤一例

患者,男,50岁。背部、前胸多发结节伴轻压痛半年余。皮损组织病理检查示:表皮角化过度、棘层肥厚;真皮全层及皮下组织间变性弥漫肿瘤细胞浸润、瘤细胞体积大,可见核分裂相。免疫组化结果:85%CD30强阳性,Ki-67约40%(+),CD3(++),LCA(+)。诊断:原发性皮肤CD30~+间变性大细胞淋巴瘤,T细胞型。     

原发性皮肤CD30+间变性大细胞淋巴瘤1例

报告1例原发性皮肤CD30+间变性大细胞淋巴瘤.患者男,72岁.右足拇趾红肿,外侧有一2.0 cm×2.5 cm红色溃疡面,伴血性液体渗出,近端有一1.5 cm×2.0 cm暗红色结节,表面结痂.皮损组织病理及免疫组化标记确诊为原发性皮肤CD30+间变性大细胞淋巴瘤.     

Primary cutaneous anaplastic large cell lymphoma

Primary cutaneous anaplastic large cell lymphoma (PC‐ALCL) is a CD30+ lymphoproliferative disorder (LPD) of the skin with a relatively good prognosis in the absence of high‐stage disease. CD30+ LPDs comprise approximately 25%‐30% of primary cutaneous lymphomas and as a group represent the second most common clonal T‐cell neoplasm of the skin behind mycosis fungoides. Diagnosis of PC‐ALCL relies strongly on clinicopathologic correlation given the potential morphologic, clinical and molecular overlap with the other cutaneous CD30+ LPD, lymphomatoid papulosis, and more aggressive hematolymphoid neoplasms.     

原发性皮肤间变性大细胞淋巴瘤4例

目的:探讨原发性皮肤间变性大细胞淋巴瘤(ALCL)临床及病理特征。方法:复习4例患者的临床资料、肿瘤组织的病理形态和免疫表型。结果:4例中男3例,女1例,平均年龄为55.5岁。患者临床上均表现为皮下结节。光镜下以75%以上CD30 间变性大细胞弥漫浸润真皮及皮下脂肪组织为特征,多数瘤细胞表达T细胞免疫表型。随访3例12~36个月肿瘤均无复发或转移。结论:原发性皮肤ALCL是少见的低度恶性T细胞性淋巴瘤,预后较好。依据其组织病理学特征及免疫组化CD30阳性标记,可与其他恶性肿瘤进行鉴别。     

ALK+ CD30+原发性皮肤间变性大细胞淋巴瘤一例

患者男,27岁.左侧腹股沟包块2个月,间断发热伴疼痛3周.皮损初起于左腹股沟内侧皮肤,为暗红色丘疹,后增大破溃,伴左腹股沟淋巴结肿大、发热.体检:左腹股沟内侧可触及直径约4 cm浸润性肿块,中央约1 cm溃疡,少许血性浆液渗出,明显触痛,皮损外侧可触及数个蚕豆大小肿大淋巴结,质硬,粘连呈条索状,活动度差.皮损组织病理检查:真皮深层至皮下脂肪层致密片状异形淋巴样细胞浸润,淋巴结穿刺部分区域见团片状异形淋巴样细胞.浸润细胞免疫组化标志示:CD30、CD43、CD45阳性,ALK表达为核浆型,诊断为ALK+ CD30+原发性皮肤间变性大细胞淋巴瘤.治疗:患者接受3次环磷酰胺+表阿霉素+长春新碱+醋酸泼尼松化疗(CEOP)后,皮疹完全消退,破溃处愈合.     

Primary cutaneous anaplastic large‐cell lymphoma: a case report

Primary cutaneous anaplastic large‐cell lymphoma (PCALCL) is a part of the spectrum of CD30+ lymphoproliferative cutaneous processes. The characteristics include single or multifocal nodules that ulcerate as skin lesion, slow disease progression, autoregressive, and recurrent in few years. The present study report the case of a 16‐year‐old boy presenting PCALCL with single nodules, ulcer, keloid, and scab in his right‐side face. He showed a good response to the treatment with systemic chemotherapy and dermatoplasty, and regained confidence after the appearance of recovery. There is no relapse of the primary lesion and organs involved till now. The chemotherapy combining with surgical excision and dermatoplasty is a good method for PCALCL, per the lesion biopsy and positron emission tomography‐computed tomography before and after treatment.     

原发性皮肤间变性大细胞淋巴瘤

报告1例原发性皮肤间变性大细胞淋巴瘤.患者女,24岁.左手中指红斑33 d,根据皮损组织病理及免疫组化标记结果诊断为原发性皮肤间变性大细胞淋巴瘤.     

Primary cutaneous eosinophil-rich anaplastic large cell lymphoma: report of an unusual case and literature review

BACKGROUND: Cutaneous, neutrophil-rich anaplastic large cell lymphoma (ALCL) is an uncommon variant of ALCL that may be confused with inflammatory dermatoses. OBJECTIVE AND METHODS: We describe an eosinophil-rich variant of ALCL occurring on the left ear without systemic involvement. The lesion had inflammatory characteristics, which led initially to a histological diagnosis of an inflammatory process. Two months later, a second biopsy diagnosed eosinophil-rich variant of ALCL. The patient underwent radiation therapy, but due to the extensive deformation and mutilation of the ear, the patient elected to have the ear amputated. We discuss the clinicopathological findings and the differential diagnosis CONCLUSIONS: To the best of our knowledge, the occurrence of a cutaneous, eosinophil-rich variant of ALCL has not been previously reported. It is important to alert pathologists to this variant of ALCL so that this possibility may be considered in the early differential diagnosis of inflammatory cutaneous conditions.     

间变性淋巴瘤激酶阴性的间变性大细胞淋巴瘤泛发性皮肤侵犯一例

患者男,37岁,入院前7个月无明显诱因右大腿出现一鹅蛋大小肿物,无明显不适,肿物逐渐增大,右大腿、臀部出现弥漫性、非凹陷性肿胀,入院前2个月全身皮肤出现暗红色丘疹、结节、斑块,部分斑块渐出现大小不一的糜烂、溃疡。实验室检查：白蛋白降低,乳酸脱氢酶显著升高。B超示浅表淋巴结肿大、融合,彩色多普勒示淋巴结内部较丰富的树枝样血流信号。CT显示右大腿及会阴部广泛淋巴结肿大伴软组织水肿,上腹部广泛淋巴结肿大,纵膈内淋巴结肿大。皮损组织病理：真皮全层致密分布单一核细胞,部分有异形性及不典型核分裂;免疫组化：CD3、CD8、CD30（阳性细胞占80%）、CD4、CD45RＯ、粒酶B 阳性,CD56、间变性淋巴瘤激酶（ＡＬＫ）、T细胞胞质内抗原1阴性。淋巴结病理：淋巴结结构完全破坏,肿瘤弥漫成片生长,肿瘤细胞比一般的大细胞淋巴瘤瘤细胞大,胞质丰富,嗜碱性或嗜双色性,细胞核偏位,呈马蹄形、肾形或分叶状,核染色质稀疏,可见单个或多个嗜碱性小核仁;免疫组化：CD2、CD4、CD3、粒酶B、上皮膜抗原（EMA）、Ki-67、CD30阳性,CD8、CD56、T细胞胞质内抗原（TIA）-1、ＡＬＫ均为阴性。诊断：间变性淋巴瘤激酶阴性的原发系统型间变性大细胞淋巴瘤泛发性皮肤侵犯。     

Primary cutaneous anaplastic CD30+ large cell lymphoma

Primary cutaneous anaplastic CD30+ large cell lymphoma (PCALCL) is part of the spectrum of primary cutaneous CD30+ lymphoproliferative disorders together with lymphomatoid papulosis. It affects mainly elderly patients and presents as skin nodules that tend to ulcerate. Histological and immunohistochemical study show the expression of CD30 antigen in more than 75 % of neoplastic cells. Currently it is considered a low grade lymphoma with favourable prognosis and good response to treatments such as local radiotherapy, methotrexate or surgery. We report a 93-year-old patient with ulcerated nodules in her right leg. Histological and immunohistochemical study confirmed the diagnosis of PCALCL, of non-B, non-T origin. The patient was treated with local radiotherapy with progressive resolution of skin nodules and absence of relapse at 6 months follow-up.     

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。     

Primary cutaneous multifocal CD30+ anaplastic large cell lymphoma

A 45-year-old male presented with asymptomatic tumors all over the body. The tumors showed no signs of ulceration or regression. There were generalized, nontender, firm to hard enlarged lymph nodes without hepatosplenomegaly. Biopsy and immunophenotyping revealed CD 30+ anaplastic primary cutaneous large cell lymphoma. Primary cutaneous anaplastic large cell lymphoma is characterized by single or grouped reddish-brown tumor nodules, which frequently tend to ulcerate. Secondary involvement of lymph nodes is seen in only 25%. The lesions responded dramatically to chemotherapy, but recurred.     

以颈部肿块为首发表现的儿童原发系统性间变性大细胞淋巴瘤一例

患儿男,3岁。因左颈部肿块6个月,迅速增大半个月于2014年2月3日就诊。2013年9月发现左颈部一花生大小皮色肿块,质硬,无不适,未予重视。约于就诊前半个月无明显诱因下肿块迅速增大,无触痛,表面无破溃、红肿,伴潮热、盗汗、瘙痒,无发热、咳嗽及其他不适,无皮肤苍白,无皮肤瘀点、瘀斑。曾于当地医院诊断为淋巴结炎,予抗感染治疗后肿块无明显缩小,遂来我院。发病后精神食欲可,大小便正常,近半个月体重减轻约1 ~ 2 kg……