原发性皮肤边缘区B细胞淋巴瘤1例

Primary Cutaneous Marginal Zone B-Cell Lymphoma:A Case Report

患者男,47岁,颊部单发红色结节3个月。皮肤科情况:左侧颊部可见一3 cm×2 cm大小半球形暗红色结节,境界清楚,质地较硬,无压痛,不可移动,表面光滑,可见粗细不一扩张的毛细血管。皮损组织病理示:表皮轻度角化,真皮层内见淋巴样细胞片状分布,包绕皮肤附属器,并向皮下脂肪组织内穿插性生长,细胞中等大小,核圆形或稍不规则、深染,间质血管丰富,内皮细胞肥大。淋巴组织增生性病变,考虑淋巴瘤。免疫组织化学染色示:CD20(+),CD79a(+),Bcl-2(95%+),Bcl-6(-),CD3(部分+),CD10(-),Ki67(25%+),IgG(散在+);CD21示滤泡结构中FDC网松散、破坏。诊断:原发性皮肤边缘区B细胞淋巴瘤。治疗:标准外科手术切除全部皮损组织,随访未见复发倾向。

A 47-year-old male presented with buccal solitary red nodules for three months.Dermatological examination showed a 3 cm×2 cm hemispherical dark red nodule on the left cheek,with a clear boundary,firm texture,non-tender,immovable,smooth surface,and dilated capillaries of varying thickness.Histopathological examination of the skin lesions showed mild keratinization in the epidermis,flaccid lymphoid cells in the dermis,surrounding the skin appendages,and interspersed into the subcutaneous adipose tissue.The cells were of medium size,with round or slightly irregular nuclei and deep staining,rich interstitial blood vessels,and endothelial cell hypertrophy.Lymphoproliferative lesions were considered as lymphoma.Immunohistochemical results:CD20(+),CD79a(+),Bcl-2(95%+),Bcl-6(-),CD3(partial+),CD10(-),Ki67(25%+),IgG(scattered+),CD21 showed loose and destroyed FDC network in follicular structure.Diagnosis:primary cutaneous marginal zone B-cell lymphoma.Treatment:All lesions were removed by standard surgery.No recurrence was observed during the follow-up.