Sugiyama Hiroko, Asagoe Kenji, Morizane Shin, Oono Takashi, Okazaki Fusako, Iwatsuki Keiji
Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Eur J Dermatol. 2008 Jan-Feb;18(1):74-7. doi: 10.1684/ejd.2008.0343. Epub 2007 Dec 18.
Patients with anaplastic large cell lymphoma (ALCL) often present with tumor-mediated skin changes, including pseudocarcinomatous hyperplasia (PCH), acquired ichthyosis, and tissue neutrophilia. We report a 58-year-old male patient with leukocyte common antigen (LCA)-negative, null cell-type ALCL associated with marked PCH mimicking undifferentiated squamous cell carcinoma. Although lymphocyte markers were lacking, the CD30 expression and the clonal rearrangement of the T-cell receptor gamma gene confirmed the diagnosis of ALCL. The patient had an aggressive clinical course, in which the tumor cells metastasized to the regional lymph nodes a few months after surgical removal of the primary lesion, and skin nodules recurred on the face despite intensive polychemotherapy, followed by autologous peripheral blood stem cell transplantation. The diagnosis of ALCL was delayed in our case because of the prominent PCH, the lack of LCA, and the unusually rapid progression of the tumor.
间变性大细胞淋巴瘤（ALCL）患者常出现肿瘤介导的皮肤改变，包括假癌性增生（PCH）、获得性鱼鳞病和组织嗜中性粒细胞增多。我们报告一名58岁男性患者，患有白细胞共同抗原（LCA）阴性的空细胞型ALCL，伴有显著的PCH，酷似未分化鳞状细胞癌。尽管缺乏淋巴细胞标志物，但CD30表达及T细胞受体γ基因的克隆重排确诊为ALCL。该患者临床病程进展迅速，原发灶手术切除数月后肿瘤细胞转移至区域淋巴结，尽管接受了强化多药化疗及随后的自体外周血干细胞移植，面部皮肤结节仍复发。由于显著的PCH、LCA缺乏以及肿瘤异常快速的进展，我们病例中ALCL的诊断被延迟。
