血管内大B细胞淋巴瘤4例临床病理分析  

Clinicopathological analysis of four cases of intravascular large B-cell lymphoma

作　　者：王文明[1] 贾倩楠[1] 方凯[1] 曾跃平[1] Wang Wenming;Jia Qiannan;Fang Kai;Zeng Yueping(Department of Dermatology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院皮肤科,北京100730

出　　处：《中华皮肤科杂志》2022年第1期27-30,共4页Chinese Journal of Dermatology

摘　　要：目的分析4例血管内大B细胞淋巴瘤(IVLBCL)的临床病理特点。方法回顾北京协和医院皮肤科2020年1-11月行皮肤组织病理确诊的4例IVLBCL患者的临床及病理资料。结果4例患者年龄57~76岁,男2例,女2例。4例出现神经系统症状,3例发热,3例运动耐量下降、憋气,3例躯体凹陷性水肿。例1背部出现0.2 cm大小樱桃状血管瘤样丘疹,例2左侧乳房及上腹部见毛细血管扩张。4例患者取材6处行组织病理及免疫组化,其中樱桃状血管瘤、毛细血管扩张2处阳性,余4处正常皮肤中2处阳性。组织病理均提示真皮血管管腔内单一核细胞聚集,细胞较大,有异型性,免疫组化染色显示CD20阳性。结论对于疑诊IVLBCL的患者,血管瘤样皮损和毛细血管扩张处取材阳性率高,正常皮肤组织活检亦可辅助早期确诊IVLBCL。Objective To investigate clinicopathological features of 4 cases of intravascular large B-cell lymphoma(IVLBCL).Methods Clinical and pathological data were collected from 4 patients with histopathologically confirmed IVLBCL in Department of Dermatology,Peking Union Medical College Hospital from January 2020 to November 2020,and retrospectively analyzed.Results The 4 patients were aged 57-76 years,including 2 males and 2 females.Of the 4 patients,all had neurological symptoms,3 had fever,3 exhibited impaired exercise tolerance and suffocation,and 3 exhibited pitting edema of the body.Case 1 presented with a cherry hemangioma-like papule measuring 0.2 cm in diameter on the back,and case 2 with telangiectasia on the left breast and upper abdomen.Six skin samples were taken from the 4 patients for histopathological and immunohistochemical studies,and tumor cells were found in 1 cherry hemangioma-like lesion and 1 lesion of telangiectasia,as well as in 2 of 4 normal skin samples.Histopathological findings mainly were dilated dermal blood vessels filled with large atypical mononuclear cells,and the atypical mononuclear cells were positive for CD20 immunohistochemically.Conclusion For those patients with suspected IVLBCL,hemangioma-like and telangiectasia lesions tend to show characteristic histopathological and immunohistochemical findings,and a biopsy of normal skin can facilitate early diagnosis of IVLBCL.

关 键 词：淋巴瘤 B细胞 血管内大B细胞淋巴瘤 樱桃状血管瘤 毛细血管扩张 

分 类 号：R732.2[医药卫生—肿瘤]