皮肤结外NK/T细胞淋巴瘤10例临床及组织病理特征分析  

Cutaneous extranodal NK/T-cell lymphoma:a clinicopathologic study of 10 cases

作　　者：杨迪[1] 刘栋华[1] YANG Di;LIU Dong-hua(Department of Dermatology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院皮肤科,广西南宁530021

出　　处：《临床皮肤科杂志》2020年第6期342-346,共5页Journal of Clinical Dermatology

摘　　要：目的:分析皮肤结外NK/T细胞淋巴瘤临床及组织病理特点。方法:收集2012年10月——2019年5月该院皮肤科诊治的10例皮肤结外NK/T细胞淋巴瘤患者,对其皮损、皮损组织病理及免疫组化等进行回顾性分析,并随访患者生存情况。结果:所有患者中男5例及女5例。4例皮损位于四肢,3例位于鼻、面部,3例泛发全身,皮损均表现为红斑、结节、溃疡及水疱。本组患者皮损组织病理均表现为不典型的淋巴细胞浸润,不规则折叠核,肿瘤细胞围绕血管中心性生长,血管阻塞破坏及凝固性坏死,可浸润至真皮及皮下组织。原位杂交示浸润的不典型淋巴细胞EB病毒编码RNA(EBER)(10例)胞核阳性。免疫组化示T细胞胞质内抗原(TIA)-1(10例)、CD3(5例)和颗粒酶B(7例)胞质阳性,CD56(6例)、CD30(3例)、CD8(2例)和CD20(2例)胞膜阳性,增殖核抗原(Ki-67)(10例)胞核约5%~90%阳性。10例患者中6例死亡,发病至死亡时间5~75个月。结论:皮肤结外NK/T细胞淋巴瘤疾病进展快,皮损泛发者提示预后不良。Objective:To analyze clinical and pathological characteristics of cutaneous extranodal NK/T-cell lymphoma.Methods:A retrospective case study of 10 patients with cutaneous extranodal NK/T cell lymphoma at the First Affiliated Hospital of Guangxi Medical University between October 2012 and May 2019 was performed.The characteristics of the clinical presenta tion,histopathology and immunohistochemistry were analyzed.All 10 patients were followed up for survival analysis.Results:Ten patients were 5 males and 5 females.The distribution of the lesions was on the extremities in 4 cases,the nose and face in 3 cases,and disseminated disease in 3 cases.The clinical presentation consisted of erythema,nodules,ulcers and blisters.Histopathological examination revealed an atypical diffuse and angiocentric lymphoid infiltrate involving dermis and subcuta neous region,in association with angio-occlusion,angiodestruction and coagulative necrosis.The tumor cells showed irregular folded nuclei.All 10 cases were positive for EBER by In situ hybridization.Immunohistochemical study showed that the tumor cells were positive for TIA-1(10 cases),Granzyme B(7 cases),cytoplasmic CD3(5 cases),CD56(6 cases),CD30(3 cases),CD8(2 cases)and CD20(2 cases).All 10 cases were positive for Ki-67 with values 5%~90%.Six of the ten patients died.The time from onset to diagnosis was 5 to 75 months.Conclusion:Cutaneous extranodal NK/T cell lymphoma is an aggressive lymphoma.Extensive cutaneous involvement may suggest a worse prognosis.

关 键 词：NK/T细胞淋巴瘤 皮肤结外 皮损 组织病理 

分 类 号：R739.5[医药卫生—肿瘤]