- 期刊
原發性皮膚廣泛性大型B細胞淋巴瘤
Primary Cutaneous Diffuse Large B Cell Lymphoma
摘要
原發性皮膚B細胞淋巴瘤是原發於皮膚，而無其他皮膚以外器官病灶的一種淋巴結外非何杰金氏淋巴瘤。吾人報告一位60歲男性患者，自從兩年多前，開始在上背部有多發性、無症狀、硬結性的紅紫色斑塊發生。組織病理學檢查顯示在真皮層具有緻密、不典型且具有大型空泡化的細胞核及明顯核仁的淋巴細胞浸潤的情形。免疫組織化學檢查顯示這些腫瘤細胞對CD20(L26)染色呈陽性，而對CD45R0(UCHL-1)染色呈陰性。為排除系統性侵犯所做的檢查，包括胸部X光、骨髓抹片、胸腹電腦斷層檢查等，均無異常發現。根據臨床及病理發現，我們診斷這是一例原發性皮膚廣泛性大型B細胞淋巴瘤。隨後，他先後接受了多重化學治病及放射治療，達到了完全緩解效果，並在之後14個月的追蹤中，並無復發的情形。同時吾人也回顧文獻中有關原發性皮膚B細胞淋巴瘤的治療選擇及其臨床效果。
關鍵字
無資料並列摘要
Primary cutaneous B-cell lymphoma (PCBCL) is an extranodal non-Hodgkin’s lymphoma that primarily appears in the skin withour detectable extracutaneous location. We report a 60-year-ord man presented with multiple asymptomatic, indurated, erythematous to violaceous plaques on his upper back for more than two years. The histopathological examination showed a dense, patchy dermal infiltrate composed mainly of atypical lymphoid cells with large vesicular nuclei and occasional prominent nucleoli. The immunohistochemical study revealed positivity of the neoplastic cells for CD20 (L26) antibody and negativity for CD45R0 (UCHL-1) antibody. The staging workup (including chest X-ray, bone marrow biopsy, CT scan of the chest and abdomen) showed no abnormality. Based on the clinicopathological and immunohistochemical findings, a diagnosis of primary cutaneous diffuse large B-cell lymphoma was made. He was treated with polychemotherapy and radiotherapy. Complete response was achieved and no recurrence was detected over a 14-month follow-up period. We also review the therapeutic options of PCBCL and their efficacy in the literature.