原发性皮肤间变性大细胞淋巴瘤13例临床病理分析  

Clinicopathological features of primary cutaneous anaplastic large-cell lymphoma

作　　者：姜锦贵[1,2] 朱伦[1] 石群立[1] 周晓军[1] 安晓静[1] 杨杰[1] 马恒辉[1] 吴波[1] 

机构地区：[1]南京军区南京总医院病理科,南京210002 [2]江苏省金湖县人民医院病理科

出　　处：《诊断病理学杂志》2012年第2期88-91,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨原发性皮肤间变性大细胞淋巴瘤(ALCL)的临床病理形态特征、免疫组化及预后特点。方法对13例原发性皮肤ALCL进行形态学观察,免疫组化标记及随访,并结合相关文献进行讨论。结果 13例原发性皮肤ALCL中,男女之比为1.6∶1,平均年龄47岁。临床表现为皮肤斑块、结节、肿块;组织学形态多样;免疫组化示CD30均(+),大多数CD3和/或CD43(+),部分EMA、GranB和perforin(+),ALK、CKpan、CD20、CD79a、HMB45、CD68、CD15和CD117(-)。13例均经外科手术切除局部病变,再辅助以化疗和∕或放疗;9例随访时间5～55个月,1例死亡。结论原发性皮肤ALCL是低度恶性淋巴瘤,预后相对较好。诊断依赖于组织病理学及免疫组化标记。本病应与弥漫性大B细胞性淋巴瘤、黑色素瘤、低分化腺癌等鉴别。Purpose To explore the clinicopathological features,immunohistochemical characters and prognosis of primary cutaneous anaplastic large cell lymphoma（ALCL）.Methods 13 cases of primary cutaneous ALCL of histopathology,immunohistochemical markers and follow-up information were analyzed and the correlated literature was reviewed.Results The primary cutaneous ALCL of 13 patients had 1.6：1 male/female ratio with an average age of 47.The patients presented with skin nodules,masses,or plaques.All patients underwent operation and received chemotherapy or radiotherapy after surgery.9 patients were subjected to follow-up of 5~55 months,and 1 patients died.Primary cutaneous ALCL showed distinctive morphological characters.All 13 primary cutaneous ALCL expressed CD30.Most of the cases expressed CD3 and/or CD43.EMA,GranB and Perforin were positive in ALCL.All the ALCL were negative for CKpan,CD20,CD79a,HMB45,CD68,ALK,CD15 and CD117.Conclusion Primary cutaneous ALCL is a form of low-grade primary cutaneous T-cell lymphoma.They have a relatively good prognosis.It is necessary to differentiate it from other type of tumors such as the diffuse large B cell lymphoma,malignant melanoma,and poorly-differentiated carcinomas.

关 键 词：皮肤 间变性大细胞淋巴瘤 免疫组化 鉴别诊断 预后 

分 类 号：R730.263[医药卫生—肿瘤]