下肢原发性皮肤弥漫大B细胞淋巴瘤

Primary cutaneous B-cell lymphomas in lower limb:a case report

报告1例原发性皮肤弥漫大B细胞淋巴瘤。患者男,59岁。因右侧小腿肿块渐增大半年余就诊。皮损组织病理检查示:真皮全层可见大量淋巴细胞及少量组织细胞弥漫性浸润,并与表皮基底层之间有明显无浸润带;增生的淋巴细胞可见较多核分裂象,细胞异形明显。免疫组化染色示:>30%的异形淋巴细胞CD20(+),>80%的异形淋巴细胞波形蛋白(+);CD3、CD68、CD34、CD45RO均(-)。采用放疗及化疗治疗,放疗总剂量为84Gy;化疗采用CHOP(环磷酰胺、长春新碱、多柔比星及泼尼松)方案,经过5次化疗后,疗效显著。

A 59-year-old male patient presented with progressive tumor in his right leg for over half a year. Histopathologic features： many large round lymphocytes and little histiocytes predominated in dermis with obvious uninfiltrated band; these cells were atypical with more mitosis. Immunohistochemical stains indicated tumor cell was positive for CD20 〉 30% with atypia, vimentin 〉80%; and negative for CD3,CD68,CD34 and CD45RO. The patient was treated with radiotherapy （84 Gy in all） and chemotherapy （five course of CHOP regimen）, getting a good response.