以皮肤损害为首发表现的结外鼻型NK/T细胞淋巴瘤1例及文献复习  

Nasal Type Extranodal NK/T Cell Lymphoma With Skin Lesions as Initial Symptom:A Case Report and Review of Literatures

作　　者：陈雪[1] 高广程[1] 

机构地区：[1]首都医科大学附属北京友谊医院皮肤性病科,北京100050

出　　处：《皮肤性病诊疗学杂志》2011年第5期310-314,共5页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：目的:报道1例皮肤结外鼻型NK/T细胞淋巴瘤,分析其临床表现、组织病理特点及治疗和预后,以提高皮肤科临床医生对本病的诊治水平。方法:通过临床表现、组织病理分析,结合免疫组化染色、EB病毒原位杂交确诊。结果:颈后皮损组织病理示真皮浅中层血管附属器周围几大灶淋巴样细胞浸润,细胞核大,胞浆透明,异型性明显。瘤细胞表达CD2、CD3、CD5、CD7、CD8、GranzymeB、Ki-67,而不表达CD56,EB病毒(+)。诊断为皮肤的结外鼻型NK/T细胞淋巴瘤。结论:结外鼻型NK/T细胞淋巴瘤具有独特的组织病理及免疫组化特征,恶性度高、易误诊、预后差。Objective：A case of cutaneous extranodal NK/T cell lymphoma was reported and analyzed for clinical and histopathologic features,treatment and prognosis,in order to increase understanding of the disease for dermatologists. Methods：Analysis of the clinical manifestations and histopathologic features of the patient was made.Immunohistochemical staining and in situ hybridization for EBER were performed. Results：Histopathological examination of lesions on posterior neck revealed several large focal infiltrates of lymphoid cells around vessels and appendages in the superficial and middle layer of dermis.The lymphoid cells showed clear cytoplasm and large nuclei with cellular atypia.Immunostaining demonstrated that the atypical lymphoid cells expressed CD2,CD3,CD5,CD7,CD8,Granzyme B and Ki-67 but not CD56.EBER in situ hybridization showed positive result.All results above coincided with the diagnosis of cutaneous extranodal NK/T cell lymphoma. Conclusion：Nasal type cutaneous extranodal NK/T cell lymphoma has particular pathological and immunohistochemical features,but it is easily misdiagnosed.Proper diagnosis is key since NK/T cell lymphoma is a high-grade malignancy with poor prognosis.

关 键 词：淋巴瘤 NK/T细胞 免疫组化 皮肤损害 

分 类 号：R739.62[医药卫生—肿瘤]