累及皮肤的套细胞淋巴瘤一例

Mantle cell lymphoma with skin involvement： a case report

患者女,51岁,确诊套细胞淋巴瘤20个月,四肢红色结节10 d.体检：左颈部及颌下区淋巴结肿大.双侧扁桃体Ⅱ度肿大.左上肢皮损组织病理示真皮及皮下组织见弥漫小淋巴细胞浸润,免疫组化示CD5、bcl-2、CD43、CD20、CyclinD1、λ均阳性,Ki-67阳性率＞70％,CD3、C10、bcl-6、CD23、CD21、κ均阴性.荧光原位杂交检测示t（11∶14）CCND1/IGH融合基因阴性.诊断：累及皮肤的套细胞淋巴瘤.治疗：给予环磷酰胺＋多柔比星＋长春新碱＋泼尼松方案治疗,病情控制,随访中.

A 51-year-old female patient,who had been diagnosed with mantle cell lymphoma for 20 months,was admitted to the hospital for erythematous nodules on extremities for 10 days.Physical examination showed left cervical and submaxillary lymphadenectasis as well as bilateral enlarged palatine tonsils （grade Ⅱ）.Histopathological examination of skin lesions on the left upper limb revealed diffuse infiltration of small lymphocytes in dermis and subcutaneous tissue.Immunohistochemical examination showed positive staining for CD5,Bcl-2,CD43,CD20,CyclinD1,λ chain and Ki-67 （〉 70 %）,but negative staining for CD3,C10,Bcl-6,CD23,CD21 and κ chain.Fluorescence in situ hybridization （FISH） showed the absence of the t（11：14）/CCND1-IGH fusion gene.The patient was diagnosed as mantle cell lymphoma with skin involvement.After treatment with cyclophosphamide,doxorubicin,vincristine and prednisone,the condition was controlled and follow up was underway.