播散型皮肤假性淋巴瘤

Scattering cutaneous lymphoplasia(pseudolymphoma):a case report

报告1例播散型皮肤假性淋巴瘤。患者男,48岁。因躯干及头面部丘疹、结节伴瘙痒3年余就诊。皮损组织病理检查:表皮基本正常,真皮内见致密结节状、以淋巴细胞为主的浸润,还可见嗜酸性粒细胞、浆细胞及组织细胞,淋巴细胞形状大小较为一致,无非典型性核,病变以真皮上半部为主,皮下组织未见异常。免疫组化检查:部分细胞CD4(++),CD8(++),CD3(++),CD45Ro(++),细胞毒颗粒相关蛋白(TIA)-1(+),穿孔素(perforin)(-),CD56(-);少数细胞CD20(++),CD79a(++);S-100蛋白部分(+),CDla部分(+)提示朗格汉斯细胞增生,特殊染色示:结核杆菌及麻风杆菌抗酸染色均(-)。诊断:播散型皮肤假性淋巴瘤(以T细胞增生为主)。

A 48-year-old, male miner worker had papules and nodules on the trunk and face accompany itching with a 3year history. Histopathology revealed epidermis was nomal. Upper half of dermis showed a dense, nodular infiltration composed chiefly of mature and uniform lymphocytes, eosinophils, dendritic cells and histiocytes. Subcutaneous tissue was normal. Immunohisto-chemistry showed that sectional lymphocytes were positive for CD4, CD8, CD3, CD45Ro and TIA-1, and were negative for perforin and CD56. A few of them were also positive for CD20, CD79. Positive of S-100 and CDla presented the proliferation of Langerhans cell. Acid-fast stain was negative. The diagnosis of cutaneous pseudo-lymphoma （mainly with T lymphocytes proliferation） was made.