皮肤淋巴瘤14例临床病理分析

目的：探讨皮肤原发性非霍奇金淋巴瘤的临床病理特点和类型，加深对皮肤淋巴瘤的认识。方法：对1984-2000年间诊断的皮肤淋巴瘤病例进行回顾性分析，并根据形态和免疫组化表达情况，按WHO新的分类标准对其进行分类。结杲：共诊断皮肤原发性非霍奇金淋巴瘤14例，占结外淋巴瘤的6％。组织学类型中，蕈样肉芽肿3例，滤泡性淋巴瘤2例，弥漫性大B细胞淋巴瘤5例，间变性大细胞淋巴瘤2例，B淋巴母细胞性白血病／淋巴瘤1例，皮下脂膜炎样T细胞淋巴瘤1例。结论：皮肤原发性淋巴瘤的临床病理表现复杂多样，需与皮肤良性淋巴组织增生与非淋巴造血系统的恶性肿瘤鉴别。临床、组织学、免疫组化相结合对于诊断和鉴别诊断很有必要，对于难以鉴别的病例，需进行长期随访观察。

Primary lymphoma of skin: a clinical and pathological analysis

Objective: To study the clinical and pathological features of primary cutaneous lymphoma,in order to get a deeper understanding of this tumor.Method: We retrospectively reviewed data of lymphoma of the skin diagnosed between 1984 and 2000,the all cases were classified dependent on their morphological feature and immunohistochemical expression under new WHO classification.Results: There were 14 cases of primary cutaneous lymphoma showing initial involvement of skin,that accounted for about 6% of extranodal lymphoma cases.The histological classification of 14 cases of primary cutaneous lymphoma included mycosis fungoides(3 cases),diffuse large B cell lymphoma(5 cases),follicular lymphoma(2 cases),anaplastic large cell lymphoma(2 cases),B lymphoblastic leukaemia/lymphoma(1 case),and subcutaneous panniculitis-like T cell lymphoma(1 case).Conclusion: The clinical and histological appearances of primary cutaneous lymphoma are varied and complicated,that needs to differentiate with cutaneous lymphoproliferative disorders and non-heamatopoietic malignancies.To combine the clinical feature with histological appearance and immunohistological expression,is necessary for diagnosis and differentiated diagnosis,a long period of follow-up is also necessary for the cases of very difficult to differentiate.