Boudova Ludmila, Kazakov Dmitry V, Jindra Pavel, Sima Radek, Vanecek Tomás, Kuntscher Vilem, Vera Vozobulova, Bouda Jiri, Michal Michal
Department of Pathology, Medical Faculty Hospital, Charles University, Pilsen, Czech Republic.
J Cutan Pathol. 2006 Aug;33(8):584-9. doi: 10.1111/j.1600-0560.2006.00488.x.
Cutaneous lymphomas co-expressing CD56 and CD30 are very rare. They share a clinicopathological overlap with natural killer- (NK)/T-cell lymphomas and anaplastic large-cell lymphomas (ALCLs), two entities with widely disparate clinical behavior.
We present a case of an immunocompetent 57-year-old Caucasian woman with a rapidly growing, angiodestructive and neuroinvasive primary cutaneous ALCL (PCALCL). The neoplastic population of large anaplastic CD30+ and CD56+ T cells was masked by a massive admixture of histiocytes and neutrophils. The partially ulcerated and pus-secreting tumor involved the forehead and scalp and was assessed as clinical stage IAE.
After chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone), the patient achieved a complete remission. Additionally, high-dose chemotherapy with autologous peripheral blood stem-cell transplantation was administered as a consolidation of complete remission, in which she has remained for 6 years.
This is the first CD30+ and CD56+ primary skin lymphoma to be reported on the head. The presented case carries a remarkable combination of clinicopathological features of PCALCL and NK-/T-cell lymphoma.
共表达CD56和CD30的皮肤淋巴瘤非常罕见。它们在临床病理上与自然杀伤(NK)/T细胞淋巴瘤和间变性大细胞淋巴瘤(ALCL)存在重叠,而后两者具有截然不同的临床行为。
我们报告一例免疫功能正常的57岁白种女性,患有迅速生长、血管破坏性和神经侵袭性原发性皮肤ALCL(PCALCL)。大量组织细胞和中性粒细胞的混合掩盖了大的间变性CD30+和CD56+T细胞的肿瘤细胞群。部分溃疡且有脓性分泌物的肿瘤累及前额和头皮,评估为临床IAE期。
化疗(环磷酰胺、阿霉素、长春新碱和泼尼松)后,患者达到完全缓解。此外,给予高剂量化疗联合自体外周血干细胞移植以巩固完全缓解,患者已维持完全缓解6年。
这是首例报道的发生于头部的CD30+和CD56+原发性皮肤淋巴瘤。该病例具有PCALCL和NK/T细胞淋巴瘤显著的临床病理特征组合。