CD20阳性的肿瘤期蕈样肉芽肿  

Mycosis fungoides in tumor stage associated with marked-expression of CD20 antigen:a case report

作　　者：谢锦莹 蔡艳霞 周英 周顺婷 祝玉 黄闽嘉 罗志强 周书文 吴玮 XIE Jinying;CAI Yanxia;ZHOU Ying;ZHOU Shunting;ZHU Yu;HUANG Minjia;LUO Zhiqiang;ZHOU Shuwen;WU Wei(Department of Dermatology,The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)

机构地区：[1]广东医科大学附属医院皮肤科,广东湛江524000

出　　处：《临床皮肤科杂志》2024年第11期666-669,共4页Journal of Clinical Dermatology

摘　　要：报告1例CD20阳性的肿瘤期蕈样肉芽肿。患者女,53岁,背部红斑伴瘙痒渐至全身12年,额部结节半年。皮肤科检查:额部见一直径约1 cm红色半圆形隆起性结节;面部、耳后、颏、颈部、腋下和手掌见较多红色略有浸润感和皱缩的斑疹和斑片,躯干、大腿见较多萎缩性褐色斑片。额部皮损组织病理检查:真皮内见淋巴样细胞弥漫增生,部分围绕附属器生长,大淋巴样细胞>25%,核扭曲,见核分裂象。免疫组化:CD3、CD4、CD5、程序性细胞死亡受体(PD-1)及CD20均(+),CD79a(部分+),CD8(散在+),CD30(>25%+),增殖核抗原(Ki-67)(30%~40%+)。T细胞受体(TCR)基因重排检测到单克隆阳性。诊断:蕈样肉芽肿(肿瘤期)伴CD20+和大细胞转化。A case of mycosis fungoides in tumor stage associated with the expression of the CD20 antigen is reported.A 53-year-old female presented with itching erythema on her back that gradually increased to her whole body for 12 years,and a nod-ule on her forehead for half a year.Physical examination revealed an erythematous semicircular nodule about 1 cm in diameter on her forehead,raised on the surface.There were slightly invasive and shrunk maculas and patches on the face,posterior aurem,chin,neck,axillae and palms.Atrophic brown patches were seen on the trunk and the thighs.Histopathological exam ination from the nodule of the forehead showed a large number of lymphoid cells in the dermis,some of which grew around the appendages and large lymphoid cells made up over 25%with distorted nucleus and common mitosis.Immunohistochemistry demon-strated positive results for CD3,CD4,CD5,CD20,PD-1 and partly positive results for CD8 and CD79a,with over 25%posi-tive for CD30 and 30%to 40%positive for Ki-67.T cell receptor gene rearrangement detection showed monoclonal rearrange-ment.Eventually,mycosis fungoides in tumor stage was diagnosed with the expression of CD20 and large cell transformation.

关 键 词：蕈样肉芽肿 B细胞 CD20 大细胞转化 

分 类 号：R739.5[医药卫生—肿瘤]