大疱性类天疱疮并发原发性皮肤弥漫性大B细胞淋巴瘤

报告1例大疱性类天疱疮并发原发性皮肤弥漫性大B细胞淋巴瘤.患者男,80岁.全身水肿性红斑伴水疱、大疱,诊断为大疱性类天疱疮.在发病7个月后,右胫前出现多个暗紫红色结节,逐渐增多、增大,并扩展至右股内侧和背部.皮损组织病理检查示真皮全层及皮下脂肪小叶弥漫致密的淋巴细胞浸润,可见多数淋巴细胞体积增大,形态不规则,核大深染,可见核分裂相.免疫组化染色:CD20( ),bcl-2( ),bcl-6( ).诊断:原发性皮肤弥漫性大B细胞淋巴瘤.在肿瘤出现后1个月,患者大疱性类天疱疮的病情出现反复,通过CHOP方案治疗,病情明显好转.

Bullous pemphigoid with primary cutaneous diffuse large B-cell lymphoma

A case of bullous pemphigoid with primary cutaneous diffuse large B-cell lymphoma is reported. An 80-year-old male patient, presented with swollen erythema, blisters and bullae on his body, was diagnosed as bullous pemphigoid (BP). Seven months later, multiple dark-purple-red nodules were found on his right lower leg. The lesions progressed and involved his right thigh and back. Skin biopsy showed a dense diffuse lymphocytic infiltration in the dermis and subcutaneous fat tissue. The lymphocytes were large and irregular, with large and dark-stained nuclei. Mitotic figures were also observed. Immunohistochemical staining showed CD20, bcl-2 and bcl-6 were positive. The final diagnose was primary cutaneous diffuse large B-cell lymphoma, leg type. BP relapsed one month later. After the treatment of systemic chemotherapy (CHOP), he achieved a great improvement.