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报告1例原发性皮肤边缘区B细胞淋巴瘤(PCMZL)。患者男,26岁。右大腿伸侧、左肩部及左前臂各一红色或紫红色浸润性斑块,大小不等,界限清楚,表面可见米粒大丘疹,无鳞屑、破溃及压痛。皮损组织病理检查:真皮层可见淋巴样细胞弥漫或结节状浸润,少量累及表皮,浸润细胞中大量小至中等大小的中心细胞样淋巴细胞,胞质透亮,可见轻度核异形;表皮下、浸润细胞周围偶见浆细胞。免疫组化:可见大量反应性的CD3+T细胞,其周围环绕的小淋巴细胞CD20、CD79a及B细胞淋巴瘤/白血病因子(Bcl)-2均(+);肿瘤细胞增殖核抗原(Ki-67)(>40%+);浆细胞限制性表达轻链-λ,不表达轻链-κ;散在肿瘤细胞CD30、CD21、CD10、Bcl-6及D型细胞周期蛋白(cyclin D)1均(+)。诊断:PCMZL。治疗:予手术切除右大腿伸侧及左肩部皮损,术后随访至今,皮损未复发及未见新发皮损。
One case of primary cutaneous borderline B-cell lymphoma (PCMZL) was reported. Male patient, 26 years old. The right thigh extensor, the left shoulder and left forearm of a red or purple infiltrative plaque, the size range, well-defined, the surface can be large rice papules, no scales, ulceration and tenderness. Skin lesions histological examination: the dermis can be seen diffuse or nodular infiltration of lymphoid cells, a small amount of involvement of the epidermis, infiltration of a large number of small to medium-sized central cell-like lymphocytes, cytoplasm translucent, showing mild nuclear abnormalities; subepidermal Infiltration of cells occasionally plasma cells. Immunohistochemistry showed that a large number of reactive CD3 + T cells with small lymphocytes around the surrounding CD20, CD79a and B cell lymphoma / leukemia factor (Bcl) -2 (+); tumor cell proliferating nuclear antigen (Ki- 67) (> 40% +). The plasma cells restricted the expression of light chain -λ, but did not express the light chain-κ. The expression of CD30, CD21, CD10, Bcl-6 and D-type cyclin D (+). Diagnosis: PCMZL. Treatment: Surgical removal of the right thigh extension and left shoulder lesions, postoperative follow-up, the skin lesions did not recur and no new skin lesions.