以皮肤肿块为首发临床表现的伴MYC和BCL2重排弥漫性大B细胞淋巴瘤  

Cutaneous nodule as initial clinical manifestation in diffuse large B-cell lymphoma with MYC and BCL2 rearrangements:a case report

作　　者：何欣[1] 刘凤磊[2] 陈城[2] 李振珺 吴先伟[3] 何乐[4] HE Xin;LIU Fenglei;CHEN Cheng;LI Zhenjun;WU Xianwei;HE Le(Department of Pathology,Gansu Provincial Cancer Hospital,Sun Yat-sen University Cancer Center Gansu Hospital,Lanzhou 730050,China;Department of Pathology,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Dermatology,Gansu Provincial Hospital,Lanzhou 730000,China;First School of Clinical Medicine,Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃省肿瘤医院、中山大学附属肿瘤医院甘肃医院病理科,甘肃兰州730050 [2]甘肃省人民医院病理科,甘肃兰州730000 [3]甘肃省人民医院皮肤科,甘肃兰州730000 [4]甘肃中医药大学第一临床医学院,甘肃兰州730000

出　　处：《临床皮肤科杂志》2024年第1期31-35,共5页Journal of Clinical Dermatology

基　　金：甘肃省人民医院院内科研基金资助项目(21GSSYB-19);甘肃省卫生行业科研计划项目(GSWSKY-2019-27)资助项目。

摘　　要：报告1例以皮肤肿块为首发临床表现的伴细胞性骨髓细胞瘤病病毒癌(MYC)基因和B细胞淋巴瘤因子2(BCL2)基因重排弥漫性大B细胞淋巴瘤。患者女,87岁。左侧眉弓上方皮肤结节1年。皮肤科检查:左眉上方一肤色圆形肿物,隆起于皮肤表面,肿物表面可见浸润性红斑,伴少许渗出,并见结痂、鳞屑,边界清楚。皮损组织病理检查:表皮形态正常,真皮层内大量母细胞样淋巴细胞结节状浸润。免疫组化:母细胞样淋巴细胞CD45、CD79a、B细胞淋巴瘤因子6(BCL6)、细胞周期蛋白D1(cyclin D1)及MYC均(+);CD3、CD2、CD30、细胞角蛋白(CKP)、间变性淋巴瘤激酶(ALK)及Epstein-Barr病毒编码RNA(EBER)均(-)。荧光原位杂交检测:MYC、BCL2及BCL6均重排。诊断:伴MYC和BCL2重排弥漫性大B细胞淋巴瘤。患者未治疗,2个月后死亡。A case of diffuse large B-cell lymphoma with MYC and BCL2 rearrangements presenting with a skin mass as the initial clinical manifestation is reported.An 87-year-old woman presented with skin nodule above the left eyebrow for 1 year.Physical examination showed a round scaly,skin-colored nodule on the upper left eyebrow with indurated erythema,a little exudation,crusty,and clear boundary.Histopathological examination revealed normal epidermis with nodular infiltration of many blastoid lymphocytes in the dermis.Immunohistochemical study showed that the blastoid lymphocytes were positive for CD45,CD79a,BCL6,cyclin D1 and MYC,and negative for CD3,CD2,CD30,CKP,ALK and EBER.Fluorescence in situ hybridization(FISH) detected rearrangements of MYC,BCL2 and BCL6.The patient was diagnosed with diffuse large B-cell lymphoma with MYC and BCL2 rearrangement.The patient was not treated and died 2 months later.

关 键 词：细胞性骨髓细胞瘤病病毒癌基因 B细胞淋巴瘤因子2基因 弥漫性大B细胞淋巴瘤 皮肤肿块 

分 类 号：R733.1[医药卫生—肿瘤]