原发性皮肤弥漫性大B细胞淋巴瘤(腿型)2例报道伴文献复习

Primary cutaneous diffuse large B cell lymphoma( leg type) : two cases reports with review of literatures

目的:通过探讨原发性皮肤弥漫性大B细胞淋巴瘤临床表现和病理特点,提高对该病的认识,实现早诊早治。方法:对2例疑似原发性弥漫性大B淋巴细胞瘤(腿型)患者进行临床表现分析及组织病理检查,通过检测细胞表面抗原标记确诊,采用利妥昔单抗联合CHOP方案化疗,21天为1个疗程,连续半年结束疗程继续随访。结果:弥漫性大B淋巴细胞瘤进展迅速,可破溃,组织病理检查表现为真皮单核细胞浸润,细胞异型明显,免疫组化表现为B细胞表型,CD20(+),CD79a(+),BCL-2(+),CD10(-),BCL-6(-),采用利妥昔单抗联合CHOP方案治疗,随访2年疗效肯定。结论:利妥昔单抗联合CHOP方案化疗连续6个疗程治疗原发性弥漫性大B细胞淋巴瘤,效果肯定。

Objective：To describe both manifestation and characteristic of immunohistochemistry for primary diffuse large B lymphocytic tumor （DLBCL）, and to faciliate an earlier diagnose and treatment. Methods： Two cases suspect of primary diffuse large B lymphocytic tumor （leg type） were confirmed by biopsy and antigen detection at cell surface through immunohistochemis- try. The combined treatment was administrated with rituximab together with CHOP regimen and followed up once half a year for two years. Results： DLBCL developed rapidly and may rupture. The histopathological findings showed that the infiltration of tumor ceils in the dermis was dominated by single lymphocytes, and there were prominent atypical cells. Immunohistochemistric results showed phenotypes of B cells, CD20（ ＋ ）, CD79a（ ＋ ）, BCL-2（ ＋ ）, whereas both CD10 and BCL-6 were negative. Follow-up evaluation at 2 years after administrated with Rituximab combined with CHOP regimen was satisfactory. Conclusion： Patients with DLBCL may benifit from multiple therapy such as Rituximab combined with CHOP regimen for 21 days as a course, six courses must be continuous.