中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2012年
3期
151-154
,共4页
陈思远%郑丽端%吴艳%夏颖%钱悦%朱里%王翠彦%孙兰%涂亚庭%黄长征
陳思遠%鄭麗耑%吳豔%夏穎%錢悅%硃裏%王翠彥%孫蘭%塗亞庭%黃長徵
진사원%정려단%오염%하영%전열%주리%왕취언%손란%도아정%황장정
淋巴瘤,非霍奇金%病例报告[文献类型]
淋巴瘤,非霍奇金%病例報告[文獻類型]
림파류,비곽기금%병례보고[문헌류형]
Lymphoma,non-Hodgkin%Case reports [Publication type]
患者女,18岁.双小腿皮肤红斑、结节伴疼痛2年余.皮肤科检查:左小腿内后侧弥漫性浸润性暗红斑,红斑范围内可触及深在大小不等皮下结节,质稍硬,伴显著触痛.皮损组织病理检查:表皮未见明显异常,真皮及皮下血管周围淋巴样细胞浸润,多处血管壁坏死及血管闭塞,部分血管内可见成团的淋巴细胞,其中可见较多核大浓染异形细胞及病理性核分裂.免疫组化染色:血管内淋巴细胞CD3(+++)、CD3ε(+++)、CD2(+)、CD56(+++)、粒酶B(+++)、穿孔素(+++)、CD30(+),Ki67(+++,100％),CD20、CD5、CD7、CD4、CD8、TdT、间变性淋巴瘤激酶、上皮膜抗原、泛细胞角蛋白均为阴性,CD34示血管(+),原位杂交显示血管内淋巴细胞EB病毒编码RNA1/2(+).诊断:皮肤血管内NK/T细胞淋巴瘤.
患者女,18歲.雙小腿皮膚紅斑、結節伴疼痛2年餘.皮膚科檢查:左小腿內後側瀰漫性浸潤性暗紅斑,紅斑範圍內可觸及深在大小不等皮下結節,質稍硬,伴顯著觸痛.皮損組織病理檢查:錶皮未見明顯異常,真皮及皮下血管週圍淋巴樣細胞浸潤,多處血管壁壞死及血管閉塞,部分血管內可見成糰的淋巴細胞,其中可見較多覈大濃染異形細胞及病理性覈分裂.免疫組化染色:血管內淋巴細胞CD3(+++)、CD3ε(+++)、CD2(+)、CD56(+++)、粒酶B(+++)、穿孔素(+++)、CD30(+),Ki67(+++,100％),CD20、CD5、CD7、CD4、CD8、TdT、間變性淋巴瘤激酶、上皮膜抗原、汎細胞角蛋白均為陰性,CD34示血管(+),原位雜交顯示血管內淋巴細胞EB病毒編碼RNA1/2(+).診斷:皮膚血管內NK/T細胞淋巴瘤.
환자녀,18세.쌍소퇴피부홍반、결절반동통2년여.피부과검사:좌소퇴내후측미만성침윤성암홍반,홍반범위내가촉급심재대소불등피하결절,질초경,반현저촉통.피손조직병리검사:표피미견명현이상,진피급피하혈관주위림파양세포침윤,다처혈관벽배사급혈관폐새,부분혈관내가견성단적림파세포,기중가견교다핵대농염이형세포급병이성핵분렬.면역조화염색:혈관내림파세포CD3(+++)、CD3ε(+++)、CD2(+)、CD56(+++)、립매B(+++)、천공소(+++)、CD30(+),Ki67(+++,100％),CD20、CD5、CD7、CD4、CD8、TdT、간변성림파류격매、상피막항원、범세포각단백균위음성,CD34시혈관(+),원위잡교현시혈관내림파세포EB병독편마RNA1/2(+).진단:피부혈관내NK/T세포림파류.
An 18-year-old female presented with painful erythema and nodules on both legs for more than 2 years.Dermatological examination showed irregularly sized,mildly indurated,tender,deep subcutaneous nodules arising in diffused infiltrated dark erythematous patches in the inner and posterior region of the left leg.Histopathology showed no significant changes in the epidermis.There were perivascular lymphoid cell infiltrates in the dermis and subcutis.Multiple sites of necrosis of blood vessel walls with vascular occlusions were noted.The lumens of some blood vessels were filled with lymphocytes,among which were many atypical cells with hyperchromatic nuclei and pathologic mitotic figures.Immunohistochemistry showed that lymphocytes in the cavities of blood vessels were positive for CD3(+++),CD3ε(+++),CD2(+),CD56(+++),granzyme B(+++),perforin(+++),CD30(+),Ki67 (+++,100％ ),but negative for CD20,CD5,CD7,CD4,CD8,TdT,anaplastic lymphoma kinase,early membrane antigen (EMA) or pan cytokeratin (pCK).The endothelial cells lining the blood vessels stained positively for CD34.The intravascular lymphocytes were also positive for EBER1/2 by in situ hybridization.A diagnosis of cutaneous intravascular NK/T cell lymphoma was made.
