中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (9): 603-605.

• 论著 • 上一篇    下一篇

皮肤血管内NK/T细胞淋巴瘤五例分析

宋琳毅1,薛燕宁2,钟连生3,陈浩4,钱伯源5,王益华6,钱齐宏1,孙建方4   

  1. 1. 苏州大学附属第一医院皮肤科
    2. 江苏省中医院皮肤科
    3. 徐州医学院附属医院皮肤科
    4. 南京 中国医学科学院北京协和医学院皮肤病研究所
    5. 苏州大学医学院附属第一人民医院皮肤科
    6. 南京鼓楼医院病理科
  • 收稿日期:2014-11-18 修回日期:2015-05-21 出版日期:2015-09-15 发布日期:2015-09-01
  • 通讯作者: 陈浩 E-mail:572164629@qq.com
  • 基金资助:

    江苏省临床医学科技专项-医学研究中心项目

Clinicopathologic analysis of five cases of cutaneous intravascular natural killer/T-cell lymphoma

  • Received:2014-11-18 Revised:2015-05-21 Online:2015-09-15 Published:2015-09-01

摘要:

目的 提高对皮肤血管内NK/T细胞淋巴瘤(CIVNKTC)的认识。 方法 回顾分析5例CIVNKTC的临床资料、组织病理学、治疗及预后,并进行讨论。 结果 5例患者中男1例,女4例,发病年龄38 ~ 83岁(平均56.2岁),均以多发皮肤斑块或结节为初发表现。组织病理显示:真皮及皮下组织内可见血管扩张,扩张的血管内可见异形淋巴样细胞,细胞核大,可见1 ~ 2个小核仁。肿瘤细胞表达CD3ε,细胞毒蛋白(T细胞限制性细胞内抗原-1,粒酶B和穿孔素)和 EB病毒编码的小RNA,不表达细胞角蛋白CK,CD20,CD79A,CD4,CD8。2例患者表达CD56。5例患者中2例进行化疗,3例未治疗。经过24个月的随访,4例死亡,仅有1例带病生存。 结论 CIVNKTC是一种罕见的结外霍奇金淋巴瘤,具有独特的组织学和免疫表型特点,病程凶险,预后极差。

Abstract:

Song Linyi *, Xue Yanning, Zhong Liansheng, Chen Hao, Qian Boyuan, Wang Yihua, Qian Qihong, Sun Jianfang. *Department of Dermatology, First Affiliated Hospital of Soochow University, Suzhou 215006, China Corresponding author: Chen Hao, Email: ch76ch@163.com 【Abstract】 Objective To improve the understanding of cutaneous intravascular natural killer/T-cell lymphoma (CIVNKTC). Methods Clinical data on five cases of CIVNKTC were collected. The histopathological feature, treatment and prognosis of CIVNKTC were retrospectively analyzed and discussed. Results Of the 5 patients, 1 was male and 4 were female. The age of onset ranged from 38 to 83 years (average, 56.2 years). All the patients presented with multiple plaques and nodules as the primary symptoms. Histopathological examination revealed vasodilatation in the dermis and subcutaneous tissue, as well as atypical lymphoid cells with large hyperchromatic nuclei containing 1 - 2 small nucleoli in dilated veins. Immunohistochemical studies of tumor cells showed positive staining for CD3ε, cytotoxic proteins (including T cell-restricted intracellular antigen-1, granzyme B and perforin) and Epstein-Barr virus (EBV)-encoded microRNA, but negative staining for cytokeratin, CD20, CD79a, CD4 and CD8. Furthermore, the tumor cells stained positive for CD56 in two patients. Among the 5 patients, only 2 received chemotherapy and the remaining received no treatment. During a 24-month follow-up, 4 patients died, and only 1 survived with the tumor. Conclusion CIVNKTC is a rare extranodal Hodgkin′s lymphoma with distinct histologic manifestations and immunophenotypes, rapid and aggressive clinical course, and poor prognosis.