原发性皮肤边缘区B细胞淋巴瘤

Primary cutaneous marginal zone B-cell lymphoma:a case report

患者男,30岁。背部散在红色结节3年余。皮损组织病理检查:真皮内淋巴细胞样细胞呈片状岛屿状浸润增生,部分细胞可见异形性,表真皮间可见无浸润带,表皮大致正常。免疫组化结果:中心细胞样小淋巴细胞Bcl-2、CD20、CD79a、mum-1(++),Kap-pa:Lambda>10;CD5、CD10、Bcl-6(-);结节周围反应性T淋巴细胞CD3、CD8(+),CD4(-)。诊断:原发性皮肤边缘区B细胞淋巴瘤。治疗:行皮损内注射糖皮质激素,皮损渐消退。

A case of primary cutaneous marginal zone B-cell lymphoma is reported. A 30-year-old man presented with multiple red nodules on his back for 3 years. Histopathological examination showed a nodular infiltrate of atypical lymphoid cells in the dermis. The upper papillary dermis is free of tumor cells with a Granz zone. The epidermis is unremarkable. The immunohistochemical studies showed that the centrocyte-like small lymphocytes were positive for Bcl-2, CD20, CD79 a and MUM-1 but were negative for CD5, CD l0 and Bcl-6. There was Kappa light chain restriction(Kappa∶Lambda>10). The surrounding dermis showed reactive T cells that were positive for CD3 and CD8 and negative for CD4. The diagnosis of primary cutaneous marginal zone Bcell lymphoma was made. The patient was treated with intralesional corticosteroids and achieved remission.