Shi Qunli, Zhou Xiaojun, Yan Xiaowen, Xu Xinyu, Yin Honglin, Zhong Tong, Shamoto Mikihiro, Qian Bin
Department of Pathology, Nanjing General Hospital of PLA, School of Clinical Medicine, Nanjing University, Nanjing 210002, China.
Chin Med J (Engl). 2002 Dec;115(12):1802-5.
To examine 10 cases with primary cutaneous CD30-positive anaplastic large cell lymphoma (ALCL), analyze their clinical manifestations and pathological and immunohistochemical features, and improve early diagnosis of this disease.
We studied the morphological characteristics of primary cutaneous CD30-positive ALCL using histopathological methods. Leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelial membrane antigen (EMA), cytokeratin (CK) and HMB45 antibodies were used to determine the expression of their respective antigens from routine paraffin samples of the patients.
Ten patients (7 men and 3 women, aged 31 to 84 years) complained of subcutaneous masses or papular eruptions over their lower trunks and extremities. Histopathologically, the lesions were composed of numerous large round or oval pleomorphic cells. The cytoplasm was usually abundant, amphophilic or basophilic, and finely vacuolated. Nuclei were commonly eccentrically localized and lobated or horseshoed in shape, and multinucleated giant cells and Reed-Sternberg-like cells were seen. Nucleoli were generally multiple and large. Of the 10 patients, tumor cells displayed positive antigen expression of CD30 in all cases, positive CD45RO in 6 cases, positive CD20 in only 1 case, but negative CD45RO and CD20 expressions in 3 cases. Two patients died at 7 weeks and 3.4 years of follow-up, respectively.
Our study highlights the importance of histopathologic features and positive CD30 staining for differentiation of this disease from other malignant skin tumors.
研究10例原发性皮肤CD30阳性间变性大细胞淋巴瘤（ALCL）患者，分析其临床表现、病理及免疫组化特征，以提高该病的早期诊断。
采用组织病理学方法研究原发性皮肤CD30阳性ALCL的形态学特征。应用白细胞共同抗原（LCA）、CD20、CD30、CD45RO、CD68、上皮膜抗原（EMA）、细胞角蛋白（CK）和HMB45抗体，从患者常规石蜡样本中检测各自抗原的表达情况。
10例患者（7例男性，3例女性，年龄31至84岁）主诉下躯干和四肢有皮下肿块或丘疹样皮疹。组织病理学上，病变由大量大的圆形或椭圆形多形性细胞组成。细胞质通常丰富，呈嗜双色性或嗜碱性，有细小空泡。细胞核通常偏位，呈分叶状或马蹄形，可见多核巨细胞和里德-斯腾伯格样细胞。核仁一般多个且大。10例患者中，肿瘤细胞均显示CD30抗原表达阳性，6例CD45RO阳性，仅1例CD20阳性，3例CD45RO和CD20表达阴性。2例患者分别在随访7周和3.4年时死亡。
我们的研究强调了组织病理学特征及CD30染色阳性对鉴别该病与其他恶性皮肤肿瘤的重要性。
