儿童良性淋巴浆细胞斑块1例  

Benign lymphoplasmacytic plaque in a child

作　　者：蒋俊青[1] 齐潇丽 李群燕[1] 顾安康[2] 张理涛[1] Jiang Junqing;Qi Xiaoli;Li Qunyan;Gu Ankang;Zhang Litao(Department of Dermatology,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China;Department of Pathology,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China)

机构地区：[1]天津市中医药研究院附属医院皮肤科,天津300120 [2]天津市中医药研究院附属医院病理科,天津300120

出　　处：《中华皮肤科杂志》2024年第9期821-824,共4页Chinese Journal of Dermatology

摘　　要：患儿男,9岁,左上肢红斑块5年余,无明显自觉症状,外用糖皮质激素、钙调磷酸酶抑制剂后改善不明显。皮肤科检查:左上肢伸侧暗红色地图状斑块,边界清,表面附着少许白色鳞屑,边缘有卫星灶。实验室检查:血尿常规及免疫相关检查未见明显异常。组织病理检查:真皮中上层大量密集的淋巴细胞、浆细胞浸润,部分脂肪间隔可见上述炎症细胞浸润,局灶形成淋巴滤泡;免疫组化:CD3滤泡间区阳性,CD20滤泡中心阳性,CD38浆细胞阳性,IgG Kappa链、IgG Lambda链均阳性;过碘酸希夫染色及抗酸染色均阴性。诊断:儿童良性淋巴浆细胞斑块。治疗:局部外用卤米松乳膏每日晨起1次、他克莫司软膏每晚1次,口服活血化瘀中药。随访6个月,皮疹略变平,颜色略变淡,无新发皮疹。继续治疗及随访中。A 9-year-old male child presented with red plaques on the left upper limb for more than 5 years without obvious subjective symptoms.Topical glucocorticoids and calcineurin inhibitors did not markedly improve his condition.Skin examination showed dark red map-like plaques with clear borders on the extensor side of the left upper limb,with a few white scales attached to the surface and satellite lesions at the edge.There were no obvious abnormalities in routine blood and urine tests or immunological examinations.Histopathological examination revealed dense infiltration of abundant lymphocytes and plasma cells in the upper and middle dermis,with some inflammatory cells infiltrating the fat septa and focal formation of lymphoid follicles;immunohistochemical study showed positive staining for CD3 in interfollicular regions,CD20 in the follicular center,and CD38 in plasma cells,as well as for IgG Kappa chain and IgG Lambda chain;periodic acid-Schiff staining and acid-fast staining both showed negative results.A diagnosis of childhood benign lymphoplasmacytic plaque was made.The patient was treated with topical halometasone cream once a day in the morning,topical tacrolimus ointment once a night,and oral traditional Chinese medicine for promoting blood circulation and removing blood stasis.After 6 months of follow-up,the skin lesions became slightly flat,slightly lighter in color,and no new lesions occurred.Treatment and follow-up were ongoing.

关 键 词：淋巴浆细胞斑块 淋巴浆细胞浸润 黏膜相关淋巴样淋巴瘤 皮肤浆细胞增多症 儿童肢端假性淋巴瘤样血管角皮瘤 

分 类 号：R739.5[医药卫生—肿瘤]