中华皮肤科杂志 ›› 2016, Vol. 49 ›› Issue (3): 208-210.

• 研究报道 • 上一篇    下一篇

皮肤及系统性浆细胞增多症一例

王霞1,赵梦洁1,朱里2,钱悦3,刘厚君2,黄长征4,陈思远5   

  1. 1. 湖北省武汉市华中科技大学附属协和医院皮肤科
    2. 武汉华中科技大学同济医学院附属协和医院皮肤科
    3. 武汉协和医院皮肤科
    4. 华中科技大学同济医学院附属协和医院皮肤科
    5. 武汉市华中科技大学同济医学院附属协和医院皮肤科
  • 收稿日期:2015-05-11 修回日期:2015-11-17 出版日期:2016-03-15 发布日期:2017-03-20
  • 通讯作者: 陈思远 E-mail:siyuanc_cn@126.com
  • 基金资助:
    国家自然科学基金青年项目

A case of cutaneous and systemic plasmacytosis

  • Received:2015-05-11 Revised:2015-11-17 Online:2016-03-15 Published:2017-03-20

摘要: 患者男,46岁。6年余前背部出现散在红褐色斑块和结节,逐渐发展至腋窝及前胸部,质地变硬,冬季稍瘙痒。实验室检查发现高丙种球蛋白血症。电子计算机断层扫描(CT)发现双肺多发结节、斑片灶,纵隔、腋窝及腹股沟淋巴结肿大,脾脏增大。皮损组织病理检查:真皮中下层可见大量淋巴细胞、组织细胞、成熟浆细胞形成的肉芽肿性浸润,并可见淋巴滤泡样结构,未见细胞异形;免疫组化染色:CD38、CD138、CD79a、κ轻链、λ 轻链均阳性。结合临床及实验室检查,诊断为皮肤及系统性浆细胞增多症。

Abstract: Wang Xia, Zhao Mengjie, Zhu Li, Qian Yue, Liu Houjun, Huang Changzheng, Chen Siyuan Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China Corresponding author: Chen Siyuan, Email: siyuanc_cn@126.com 【Abstract】 A 46-year-old male patient developed scatterred reddish-brown plaques and nodules on the back 6 years prior to the presentation. Then, the lesions gradually spread to the axillary fossa and protothorax, and became indurated with slight itching in winter. Laboratory examination revealed hypergammaglobulinemia. Computed tomography (CT) scan showed multiple nodular or patchy shadows in both lungs, lymphadenectasis in axillary, mediastinal and inguinal regions, and spleen enlargement. Histopathological examination of skin lesions showed granulomatous infiltrates with plenty of lymphocytes, histiocytes and mature plasma cells in the middle and lower dermis with the presence of lymphoid follicle-like structures, but no cell atypia was observed. Immunohistochemical study showed positive staining for CD38, CD138, CD79a, κ and λ light chains. According to clinical manifestations and laboratory examination results, the patient was diagnosed with cutaneous and systemic plasmacytosis.

中图分类号: 

  • R75