A rare localised nasal CD30+ primary cutaneous T-cell lymphoma following liver transplantation.
A rare localised nasal CD30+ primary cutaneous T-cell lymphoma following liver transplantation.
复制标题
肝移植后罕见的局限性鼻 CD30 原发性皮肤 T 细胞淋巴瘤。
DOI：
10.1136/bcr-2017-221028
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发表时间：
2017
期刊：
影响因子：
0.9
通讯作者：
Frenette,CatherineT
中科院分区：
文献类型：
--
作者：
Nhu,QuanM;Du,EmmaZ;Kiyani,Amirali;Frenette,CatherineT
皮肤 T 细胞移植后淋巴增殖性疾病 (PTLD) 是一种罕见的临床表现，如果不及早发现和干预，实体器官移植受者可能会变得具有攻击性。我们遇到了一个罕见的病例，原发性皮肤 CD30 阳性、Epstein-Barr 病毒阴性的 T 细胞来源的间变性大细胞淋巴瘤 (ALCL)，表现为一名 71 岁男性在原位肝移植 4 年后出现孤立性鼻尖病变。部分鼻切除术的切除活检显示上皮下弥漫性中型至大型淋巴细胞浸润，具有圆形至不规则的细胞核、部分浓缩的染色质和突出的核仁。免疫表型研究显示 CD30 阳性原发性皮肤 ALCL。正电子发射断层扫描/CT 成像显示局部活动性疾病，并开始放射治疗并获得完全缓解。在评估移植后患者的皮肤病变时，高度怀疑 PTLD 对于早期识别、及时诊断和及时干预至关重要，同时治愈性治疗的窗口仍然存在。
Cutaneous T-cell post-transplant lymphoproliferative disorder (PTLD) is a rare clinical presentation that can potentially turn aggressive in solid-organ transplant recipients if not detected and intervened on early. We encountered a rare case of rapidly worsening primary cutaneous CD30-positive, Epstein-Barr virus-negative anaplastic large cell lymphoma (ALCL) of T-cell origin, manifesting as an isolated nasal tip lesion in a 71-year-old man 4 years after orthotopic liver transplantation. Excisional biopsy with partial rhinectomy showed subepithelial diffuse infiltration of medium-to-large lymphoid cells having round-to-irregular nuclei, partially condensed chromatin and prominent nucleoli. Immunophenotypic studies revealed CD30-positive primary cutaneous ALCL. Positron emission tomography/CT imaging revealed a locally active disease, and radiation therapy was initiated with complete response. A high index of suspicion for PTLD when evaluating skin lesions in a post-transplant patient is paramount for its early recognition, prompt diagnosis and timely intervention while the window for curative therapy remains possible.