原发性皮肤CD_(30)^+间变性大细胞淋巴瘤1例

A case of Primary Cutaneous CD_(30)^+ Anaplastic Large Cell lymphoma

患者男,71岁。右上肢反复出现结节2年。右肘部外侧密集数十个蚕豆至核桃大结节,部分表面破溃。右上胸部有片状浸润性斑块、结节。右肘部结节组织病理示:真皮全层及皮下脂肪均可见肿瘤细胞呈弥漫、致密浸润性生长,无亲表皮现象,肿瘤细胞为淋巴样细胞,体积较大,形态多样,明显异型性。免疫组化示:肿瘤细胞CD30强阳性,Ki67细胞增殖指数约80%,CD43阳性,LCA,CD45RO,CD3部分阳性,ALK,EMA,CD15,CD10,CD20,CK-P,S-100,HMB45,Vimentin,TDT及CD68均阴性。诊断:原发性皮肤CD3+0间变性大细胞淋巴瘤(PC-ALCL)。采用COP方案化疗一个周期,2个月后皮损全部复发,死亡。

Report a 71-year-old male patient.Right upper extremity had iteretured nodus for 2 years.The right lateral elbow occurred a lot of nodus with the size nealy from broad bean to walnut and some of them had ulcers.The right upper breast had lamellar invasive nodus.The integumentum damage of the right elbow nodus histopathologically,the whole derma and the subcutaneous fat were full of tumor cells,without epidermis offended.The tumor cells were lymphoid-like with large volume or pleomorphic cells,obviously heteromorphism.The immunohistochemitry mark showed the tumor cells were significantly positive with CD30,the cell proliferation with Ki67 was nearly 80%,samely positive with CD43,partly positive with LCA、CD45RO、CD3,but negative with ALK、EMA、CD15、CD10、CD20、CK-P、S-100、HMB45、Vimentin、TDT and CD68.The pathologic diagnose was primary cutaneous CD30-posivitive anaplastic large cell lymphoma （PC-ALCL）.We applyed COP plan to chems once cycle.All of the integumentum damages recurred 2 monthes later and the patient died.