CAJ | 학술논문

目的探讨急性单核细胞性皮肤白血病的临床病理特征.方法回顾分析4例以皮肤表现为首发症状的急性单核细胞性白血病患者.结果患者均为老年人,年龄分别为68、70、74、82岁.皮疹多表现为淡红色至紫色,质韧的丘疹、结节、斑块,多见于躯干和四肢.无明显自觉症状.皮损组织病理:真皮内大量肿瘤细胞密集、弥漫浸润.肿瘤细胞不亲表皮,与表皮形成明显无浸润带.可见肿瘤细胞围绕血管和附属器结构呈同心层状排列或排列成单行穿梭于胶原纤维束间.肿瘤细胞中等大小,肾形或卵圆形,异形性明显.免疫组化染色结果:肿瘤细胞CD68、CD4、CD45RO、CD56、白细胞共同抗原(LCA)阳性;CD3、CD20、CD30、CD34、CD117,CD123阴性.结论该病多见于老年人,组织病理表现为真皮全层胶原纤维间密集均匀一致的肿瘤样细胞浸润,与表皮间存在无浸润带.
목적 탐토급성단핵세포성피부백혈병적림상병리특정.방법 회고분석4례이피부표현위수발증상적급성단핵세포성백혈병환자.결과 환자균위노년인,년령분별위68、70、74、82세.피진다표현위담홍색지자색,질인적구진、결절、반괴,다견우구간화사지.무명현자각증상.피손조직병리:진피내대량종류세포밀집、미만침윤.종류세포불친표피,여표피형성명현무침윤대.가견종류세포위요혈관화부속기결구정동심층상배렬혹배렬성단행천사우효원섬유속간.종류세포중등대소,신형혹란원형,이형성명현.면역조화염색결과:종류세포CD68、CD4、CD45RO、CD56、백세포공동항원(LCA)양성;CD3、CD20、CD30、CD34、CD117,CD123음성.결론 해병다견우노년인,조직병리표현위진피전층효원섬유간밀집균균일치적종류양세포침윤,여표피간존재무침윤대.
Objective To analyze the clinicopathological features of acute monocytic leukemia cutis.Methods A retrospective study was performed on four patients with acute monocytic leukemia with skin lesions as the initial presentation.Results All the patients were elderly people with the age being 68,70,74 and 82 years respectively.Typical cutaneous lesions were multiple,reddish or purple,tenacious papules,plaques,or nodules involving the trunk and extremities.There was no obvious subjective symptom.Histopathologically,there was a dense and diffuse infiltration of numerous monomorphous tumor cells in the dermis,which were medium-sized,kidney-or oval-shaped with obvious atypia and arranged concentrically around blood vessels or appendages or linearly between collagen fibers.An uninvolved zone of papillary dermis that separated the normal epidermis from the underlying dermal infiltrate was observed.Immunohistochemical analysis showed that the tumor cells were positive for CD68,CD4,CD45RO,CD56,leukocyte common antigen (LCA),but negative for CD3,CD20,CD30,CD34,CD117 and CD123.Conclusions Acute monocytic leukemia cutis mainly occurs in elderly people,which is pathologically characterized by a dense monomorphous infiltration of tumor cells between collagen fibers throughout the dermis as well as an uninvolved zone between the dermis and epidermis.