原发性皮肤侵袭性亲表皮CD8^(+)细胞毒性T细胞淋巴瘤1例

Primary Cutaneous Aggressive Epidermotropic Cytotoxic CD8^(+)T-Cell Lymphoma:A Case Report

患者女,74岁,右背部红斑伴糜烂、溃疡8个月余,加重1个月。皮疹初起为红斑,迅速增大伴糜烂、溃疡。皮损组织病理示:真皮浅中层中小异型淋巴细胞弥漫浸润,免疫组织化学示:CD3(80%+)、CD8(80%+)、CD4(50%+)、CD30(背景细胞+)、CD20(背景B细胞+)、CD56(10%+)、CD138(-)、TIA-1(80%+)、Granzyme B(60%+)、ALK(-),Ki67(60%+)。T细胞基因重排:TCR-β(+)。诊断:原发性皮肤侵袭性亲表皮CD8+细胞毒性T细胞淋巴瘤。经8次CHOP化疗后患者皮损愈合,随访3个月后患者病情复发。

A 74-year-old female presented with erosion and ulcers on her right back for more than 8 months,which were aggravated for 1 month.The rash started as erythema and expanded rapidly with erosion and ulceration.Histopathology revealed diffuse infiltration of small and medium-sized atypical lymphocytes in the superficial and middle dermis.Immunohistochemistry showed CD3(80%+),CD8(80%+),CD4(50%+),CD30(background cell+),CD20(background B cell+),CD56(10%+),CD138(-),TIA-1(80%+),Granzyme B(60%+),ALK(-)and Ki67(60%+).T-cell receptor(TCR)-βgene rearrangement was positive.A diagnosis of primary cutaneous aggressive epidermotropic cytotoxic CD8+T-cell lymphoma was made.After 8 cycles of CHOP chemotherapy,the lesions healed and the patient relapsed at 3-months follow-up.