C型淋巴瘤样丘疹病1例并文献复习

发布时间：2018-04-24 14:51

本文选题：淋巴组织增生性疾病 + 淋巴瘤样丘疹病　；参考：《中国皮肤性病学杂志》2016年10期

【摘要】：患者男,18岁。躯干及四肢泛发丘疹并结节1月余。患者前胸、后背及四肢散在分布直径0.5~2.0cm大的丘疹及结节,部分皮疹顶端可见坏死及结痂。淋巴结B超提示双侧颈部及左侧腋窝多发淋巴结可见。左下肢皮损组织病理示真皮全层血管及附属器周围大量单一核细胞呈"楔形"浸润,部分细胞核大并可见核丝分裂相;免疫组化示CD30、CD4、CD8、CD68、Bcl-2、Bcl-6、TIA-1阳性(+),CD3、CD20、CD23、CD56、ALK-、PAX5及EBER原位杂交阴性(-),Ki-67(50%阳性)。符合C型淋巴瘤样丘疹病。每日予口服强的松片20mg及每周口服甲氨蝶呤10mg,1个月后皮疹明显减少和面积明显缩小。淋巴瘤样丘疹病属于原发性皮肤CD30+淋巴增生性疾病,有自限性,目前研究认为淋巴瘤样丘疹病组织学可分为A,B,C,D和E五型。该病一般预后较好,通常无需治疗。
[Abstract]:The patient was 18 years old. Extensive papules and nodules in the trunk and extremities are more than 1 month old. The anterior chest, back and extremities were scattered in papules and nodules with a diameter of 0.5~2.0cm. Necrosis and scab were found at the top of some rashes. Multiple lymph nodes in bilateral neck and left armpit were revealed by B-ultrasound. In the lesions of the left lower extremity, a large number of mononuclear cells were found to be "wedge-shaped" infiltrated around the whole dermal vessels and appendages, and some of the nuclei were large and mitotic, and the immunohistochemical staining showed that CD30, CD4, CD68, CD68, Bcl-2, Bcl-6, TIA-1 were positive (CD3CD20, CD23, CD56, ALK-PAX5, and EBER in situ hybridization negative, Ki 67 50%), and CD30, CD4, CD8, CD68, CD68, Bcl-2, Bcl-6, TIA-1, and CD3CD20, CD23, CD56, ALK-PAX5, and EBER in situ hybridization. Concomitant with type C lymphomatoid papulosis. Oral prednisone 20mg and methotrexate 10 mg a week reduced the rash and area significantly after one month. Lymphomatoid papulosis is a primary cutaneous CD30 lymphoproliferative disease, which is self-limited. The disease generally has a good prognosis and usually does not require treatment.
【作者单位】：新疆医科大学第一附属医院皮肤科;
【分类号】：R758.6

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