皮肤的结外鼻型NK/T细胞淋巴瘤1例及文献复习  

Cutaneous Extranodal NK/T-cell Lymphoma,Nasal-type:One Case Report and Literature Review

作　　者：王婷婷[1] 衡琨[1,2] 王琳[1] 万川[1] 徐晨[1] 刘宏杰[1] 刘卫平[3] 李甘地[3] 

机构地区：[1]四川大学华西医院皮肤性病科 [2]四川省广安市人民医院皮肤科,四川广安638001 [3]四川大学华西医院病理科

出　　处：《中国皮肤性病学杂志》2007年第3期150-153,共4页The Chinese Journal of Dermatovenereology

基　　金：2004年四川大学青年科学研究基金(编号:校200350);2005年四川大学华西医院留学回国人员科研启动基金(编号:136050122)

摘　　要：目的报道1例皮肤结外鼻型NK/T细胞淋巴瘤,以引起临床和病理医师对此病的关注。方法通过临床病理分析结合免疫组化染色、EB病毒原位杂交及T细胞受体基因重排的PCR检测分析确诊。结果左膝内后方皮损初次活检诊断为结节性脂膜炎,1个月内再次活检示真皮和皮下脂肪内肿瘤大片坏死,瘤细胞异型性明显,血管中心性浸润和血管坏死。瘤细胞表达CD2,CD8,CD45RO,CD56,TIA-1,GranzymeB和LMP-1,EB病毒(+);未检测到TCR-γ的克隆性基因重排。诊断为皮肤的结外鼻型NK/T细胞淋巴瘤。结论皮肤的结外鼻型NK/T细胞淋巴瘤恶性度高、易误诊、预后差;诊断有赖于常规组织病理结合分子病理技术。Objective To reported one case of cutaneous extranodal NK/T-cell lymphoma,nasal-type to draw the attention of physicians and pathologists. Methods The clinicopathologic analysis,immunohistochemistry,in situ hybridization for EBER and PCR for TCR-γ gene rearrangement were employed in this study. Results It was diagnosed as a benign panniculitis histologically in the first biopsy,Thus in the second biopsy a month later,there were extensive necrosis with obvious atypical lymphocytes, angiocentricity and angiodestruction in the dermis and subcutis. The tumor cells were positive for CD2, CD8, CIM5RO, CD56, TIA-1, GranzymeB,LMP-1 ,and the EBER was detected by in situ hybridization, No monoclonal gene rearrangement of TCR-γ was found. All coincidence with cutaneous extranodal NK/T-cell lymphoma. Conclusion Cutaneous extranodal NK/T-cell lymphoma, nasaltype,is a high-grade malignancy with poor prognosis. The diagnosis depends on routin histopathological and molecular pathological techniques.

关 键 词：淋巴瘤 NK/T细胞 皮肤 

分 类 号：R739.5[医药卫生—肿瘤]