原发性皮肤CD30^(+)淋巴细胞增殖性疾病:交界性肿瘤1例  

Primary Cutaneous CD30^(+) Lymphoproliferative Disorders:A Case of Borderline Tumor

作　　者：谈桂其 李春红[1] 梁晓冬 邓新华 TAN Guiqi;LI Chunhong;LIANG Xiaodong;DENG Xinhua(Department of Dermatology,the Affiliated Shunde Hospital of Jinan University,Foshan 528300,China)

机构地区：[1]暨南大学附属顺德医院皮肤科,广东佛山528300

出　　处：《中国皮肤性病学杂志》2021年第8期908-910,914,共4页The Chinese Journal of Dermatovenereology

摘　　要：患者女,27岁,右侧臀部丘疹、结节3周余。查体:右侧臀部可见两个孤立类椭圆形红色结节,硬币至鹌鹑蛋大小,表面糜烂,结节周围可见淡红色丘疹呈"卫星灶"样改变,轻压痛。皮损组织病理示:真皮内弥漫淋巴细胞、组织细胞样细胞浸润,局灶中性粒细胞、嗜酸性粒细胞聚集,可见淋巴样细胞破坏毛囊上皮,个别细胞较大。免疫组织化学:大细胞表达CD3、CD4、CD45Ro、CD30;其余细胞CD20、CD68(部分+),CD8、CD56(少数+),颗粒酶B、TIA-1(+),EMA、ALK(-),Ki-67(10%+);EBER原位杂交(-);TCR基因重排结果示TCR-β和TCR-γ均阳性;抗酸染色、PAS染色(-);符合原发性皮肤CD30^(+)淋巴细胞增殖性疾病:交界性肿瘤。门诊予换药及氦氖激光照射,1个月后皮疹基本消退,随访3个月未见复发。A 27-year-old women presented with papules and nodules on the right hip for more than three weeks.Physical examination showed two solitary ellipsoidal red nodules in size to a coin to a quail egg,with erosion on the surface.Pale red papules(as"satellite lesions")could be seen around the nodules,and with mild pressing pain.Histopathology revealed diffuse lymphocyte and histiocytic cell infiltration in the dermis,neutrophils and eosinophilic granulocytes local aggregation.The follicular epithelium was destroyed by lymphocytes,and some cells were larger.Immunohistochemistry showed large cells positive for CD3,CD4,CD45Ro and CD30,other cells positive for CD20,CD68(partially),CD8,CD56(minority),GranzymeB and TIA-1.negative for EMA,ALK and EBER,The proliferation index of Ki-67 was about 10%.TCR gene rearrangement showed TCR-βand TCR-γpositive.Acid-fast and PAS staining was negative.The diagnosed of primary cutaneous CD30+lymphoproliferative disorders:borderline tumor was made.The lesion subsided after 1 month of clinical dressing change and He-Ne laser irradiation.No recurrence was found during 3 months of follow-up.

关 键 词：原发性皮肤CD30^(+)淋巴细胞增殖性疾病 淋巴瘤样丘疹病 原发性皮肤CD30^(+)间变性大细胞淋巴瘤 交界性肿瘤 

分 类 号：R739.5[医药卫生—肿瘤]