CAJ | 학술논문

患儿4个月始发病,以额头、四肢皮肤出现多发皮色结节为特征,一般情况好,未触及肝、脾、淋巴结肿大、睾丸无明显异常、牙龈无异常增生.皮损组织病理:表皮大致正常,真皮及皮下弥漫浸润的异形细胞,体积中等偏大,胞质少,核椭圆形,不规则形,染色质细,个别细胞可见核沟及核仁.免疫组化:S-100蛋白阳性,CD68阳性；CD1阴性,Ki-67阳性率40％；CD21阴性,CD4部分细胞弱阳性.髓过氧化物酶( MPO)阴性,CD56阳性,CD123阳性,CD163阳性.骨髓片见原、幼单核细胞占0.245.诊断:以皮肤单核细胞肉瘤为首发的急性单核细胞白血病.
환인4개월시발병,이액두、사지피부출현다발피색결절위특정,일반정황호,미촉급간、비、림파결종대、고환무명현이상、아간무이상증생.피손조직병리:표피대치정상,진피급피하미만침윤적이형세포,체적중등편대,포질소,핵타원형,불규칙형,염색질세,개별세포가견핵구급핵인.면역조화:S-100단백양성,CD68양성；CD1음성,Ki-67양성솔40％；CD21음성,CD4부분세포약양성.수과양화물매( MPO)음성,CD56양성,CD123양성,CD163양성.골수편견원、유단핵세포점0.245.진단:이피부단핵세포육류위수발적급성단핵세포백혈병.
A 1-year-old boy developed multiple skin-colored nodules on the forehead and extremities when he was 4 months old.Physical examination revealed that his general condition was well with no hepatomegaly,splenomegaly,lymphadenectasis,testicle abnormality or gingival hypertrophy.Pathologically,the epidermis was normal,while the dermis and subcutaneous tissue were diffusely infiltrated with medium-to large-sized deformed cells,which had a small amount of cytoplasm,oval nucleus,irregular shape and fine chromatin.Some infiltrating cells had nuclear groove and nucleoli.Immunohistochemical studies showed that the tumor cells were positive for S-100 protein,CD56,CD123,CD163,CD68,Ki-67 (40％),weakly positive for CD4 (some),but negative for myeloperoxidase,CD1,CD21.Bone marrow smears showed a 24.5％ infltration by monoblasts and promonocytes.A diagnosis of monoblastic sarcoma cutis preceding acute monoblastic leukemia was made.