原发性皮肤弥漫性大B细胞淋巴瘤,腿型

A case of primary cutaneous diffuse large B-cell lymphoma,leg type

报告1例原发性皮肤弥漫性大B细胞淋巴瘤,腿型。患者男,77岁。双小腿出现多个红褐色斑块和结节半年。皮损组织病理检查:肿瘤细胞无嗜表皮现象,表皮与真皮之间可见一条无细胞的透明带,真皮内可见较大的异形淋巴细胞样细胞浸润,肿瘤细胞体积大,大部分呈明显的圆形,细胞核大异形性明显,核分裂象易见。免疫组化:CD20(+)、CD79α(+)、B细胞淋巴瘤(B-cell lymphoma,Bcl)-2(+)、B细胞特异性激活蛋白(Pax)-5(+)、多发性骨髓瘤癌基因1(multiple myeloma oncogene 1,MUM1)(+)、肌酸激酶(CK)(-)、CD3(-)、Bcl-6(-)、CD10(-)、细胞周期素d1(Cyclin D-1)(-)、黑色素A(Melan A)(-)、CD7(-)、生长因子受体结合蛋白(Gr B)(-)、CD30(-)、CD56(-)、CD4(-)、CD8(-)及细胞核增殖抗原(Ki-67)约80%(+)。诊断:原发性皮肤弥漫性大B细胞性淋巴瘤,腿型。经过R-CHOP方案(环磷酰胺+表柔比星+长春新碱+泼尼松)化疗后,肿块明显退缩。

A case of primary cutaneous diffuse large B-cell lymphoma（leg type）is reported.A 77-year-old man manifested multiple red-brown plaques and nodules on the both low legs about half a year.Histopathologic examination revealed cell free zone between the epidermis and the dermis,large and atypical lymphoid cell infiltration in the dermis,but no epidermotropism.Majority of tumor cells are round with atypical nuclei and some with mitotic activity.Immunohistochemistry demonstrated CD20（＋）,CD79α（＋）,Bcl-2（＋）,Pax-5（＋）,Mum-1（＋）,CK（-）,CD3（-）,Bcl-6（-）,CD10（-）,Cyclin D-1（-）,Melan A（-）,CD7（-）,Gr B（-）,CD30（-）,CD56（-）,CD4（-）,CD8（-）and Ki-67（＋80%）.The patient was diagnosed with primary cutaneous diffuse large B-cell lymphoma（leg type）After R-CHOP chemotherapy,the tumor size became smaller.