伴13q缺失的亚临床慢性淋巴细胞性白血病首发皮肤表现:1例报道  

Subclinical chronic lymphocytic leukaemia associated with a 13q deletion presenting initially in the skin: Apropos of a case

作　　者：Khandelwal A. SeilstadK.H. MagroC.M. 李政霄 

机构地区：[1]Department of Pathology, Ohio State University, N305 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, United States Dr.

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第6期9-10,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Introduction: B-cell chronic lymphocytic leukaemia (B-CLL) represents a low grade B-cell lymphoproliferative disease that is the most common leukaemia in adults. The neoplastic cell is an autoreactive CD5 CD23 B lymphocyte. B-CLL may involve the skin, typically in the context of known disease. We present a case of subclinical B-CLL presenting initially in the skin. Case Report: A 73-year-old male developed a lesion on his right cheek in April 2003 compatible with basal cell carcinoma. The re-excision specimen contained a well-differentiated atypical lymphocytic infiltrate consistent with B-CLL along with residual carcinoma. Subsequent laboratory studies revealed peripheral blood lymphocytosis with smudge cells. A diagnosis was made of Rai stage 0 CLL. Chromosomal studies on peripheral blood showed a deletion at 13q14.3. Excision of a second primary skin carcinoma revealed a squamous cell carcinoma in association with B-CLL that was identical to his previously diagnosed skin involvement. Conclusion: This case identifies a cutaneous presentation of subclinical B-CLL. There are two prior reports describing B-CLL presenting initially in the skin. In one case, the infiltrates were incidental on a reexcision specimen. The second report suggests 16%of B-CLL patients have cutaneous manifestations as the first sign of disease.Introduction： B-cell chronic lymphocytic leukaemia （B-CLL） represents a low grade B-cell lymphoproliferative disease that is the most common leukaemia in adults. The neoplastic cell is an autoreactive CD5 CD23 B lymphocyte. B-CLL may involve the skin, typically in the context of known disease. We present a case of subclinical B-CLL presenting initially in the skin. Case Report： A 73-year-old male developed a lesion on his right cheek in April 2003 compatible with basal cell carcinoma. The re-excision specimen contained a well-differentiated atypical lymphocytic infiltrate consistent with B-CLL along with residual carcinoma. Subsequent laboratory studies revealed peripheral blood lymphocytosis with smudge cells. A diagnosis was made of Rai stage 0 CLL. Chromosomal studies on peripheral blood showed a deletion at 13q14.3. Excision of a second primary skin carcinoma revealed a squamous cell carcinoma in association with B-CLL that was identical to his previously diagnosed skin involvement. Conclusion： This case identifies a cutaneous presentation of subclinical B-CLL. There are two prior reports describing B-CLL presenting initially in the skin. In one case, the infiltrates were incidental on a reexcision specimen. The second report suggests 16% of B-CLL patients have cutaneous manifestations as the first sign of disease.

关 键 词：B细胞慢性淋巴细胞性白血病 皮肤表现 首发症状 亚临床 外周血染色体检查 淋巴细胞增殖性疾病 B-CLL 淋巴细胞浸润 淋巴细胞增多 病例报道 

分 类 号：R733.72[医药卫生—肿瘤] R751[医药卫生—临床医学]