Secondary skin involvement by systemic de novo CD5-positive diffuse large B-cell lymphoma.
Secondary skin involvement by systemic de novo CD5-positive diffuse large B-cell lymphoma.
复制标题
全身性新发 CD5 阳性弥漫性大 B 细胞淋巴瘤继发性皮肤受累。
DOI：
10.1111/1346-8138.14082
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Kanekura T.
中科院分区：
文献类型：
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作者：
Baba N;Fujii K;Ibusuki A;Higashi Y;Kawai K;Kanekura T.
一位88岁女性，右脸颊皮肤肿瘤（图1a）伴鼻塞1个月。她没有淋巴组织增生性疾病的病史，也没有B症状。体格检查发现一个25毫米9 - 12毫米，暗红色斑块在鼻轭褶皱没有压痛。皮肤活检显示大的非典型淋巴样细胞弥漫性浸润整个真皮和标本的底部边缘（图1b，c）。免疫组化显示肿瘤细胞表达CD 20、CD 79 a、BCL 2和BCL 6。它们也为CD 5阳性（图1d-h）。CD 10、CD 56、MUM 1和cyclin D1均为阴性，EB病毒编码的sRNA原位杂交也为阴性。还观察到许多小淋巴细胞，这些细胞为CD 3阳性（图1 i），还观察到组织细胞。Southern杂交未能检测到IgH基因的单克隆重排。活检标本的核型分析显示11号和14号染色体以及两条标记染色体（46，XX，-11，-14，+ 2 mar）缺失。外周血分析未发现显著异常;血清化学（包括乳酸脱氢酶）在正常范围内。血清可溶性白细胞介素-2受体为6792 U/mL（范围，
Dear Editor, An 88-year-old woman presented with a 1-month history of a cutaneous tumor on her right cheek (Fig. 1a) with nasal obstruction. She had no history of lymphoproliferative disorders and did not have B symptoms. Physical examination revealed a 25 mm 9 12 mm, dark red colored plaques at the nasojugal fold without tenderness. Skin biopsy showed diffuse infiltration of large atypical lymphoid cells throughout the dermis and at the bottom marginal edge of the specimen (Fig. 1b, c). Immunohistochemically, the tumor cells expressed CD20, CD79a, BCL2 and BCL6. They were also positive for CD5 (Fig. 1d–h). CD10, CD56, MUM1 and cyclin D1 were negative, as was Epstein–Barr virus-encoded sRNA in situ hybridization. Many small lymphocytes were also seen and these cells were CD3 positive (Fig. 1i), and histiocytes were also observed. Southern blot analysis failed to detect monoclonal rearrangement of the IgH gene. Karyotype analysis of the biopsy specimen revealed the deletion of chromosomes 11 and 14 and two marker chromosomes (46, XX,-11,-14,+ 2 mar). Peripheral blood analysis did not identify significant anomalies; serum chemistry including lactate dehydrogenase was within normal limits. Serum soluble interleukin-2 receptor was 6792 U/mL (range,