Sander C A, Medeiros L J, Abruzzo L V, Horak I D, Jaffe E S
Hematopathology Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892.
J Am Acad Dermatol. 1991 Dec;25(6 Pt 1):1023-31. doi: 10.1016/0190-9622(91)70302-i.
Six patients with malignant lymphoma of lymphoblastic type involving cutaneous sites at time of diagnosis are presented. Skin sites of the head and neck were involved in all patients and included the scalp (three patients), forehead (two patients), and malar region of the face (one patient). Two patients also had additional sites of skin disease (neck, breast, and anterior trunk). In two patients the skin was the predominant site of disease, whereas in the remaining patients staging workup revealed generalized lymphoma. The histologic findings in each patient were typical of lymphoblastic lymphoma; the neoplastic cells were small with blastic nuclear chromatin. In three patients the neoplastic cells were convoluted, and in three they were nonconvoluted. Immunophenotypically, four lymphomas were of pre-B cell type, and two lymphomas were of T cell type. There was no correlation between histologic features and the immunophenotype. Since the majority of lymphoblastic lymphomas are of T cell type, the predominance of pre-B cell tumors involving the skin may suggest that pre-B cell neoplasms have a predilection for cutaneous involvement. In further support of this hypothesis, both lymphomas that appear to have arisen in the skin had a pre-B cell immunophenotype.
本文报告了6例诊断时累及皮肤部位的淋巴母细胞型恶性淋巴瘤患者。所有患者的头颈部皮肤部位均受累，包括头皮（3例）、前额（2例）和面部颊部区域（1例）。2例患者还存在其他皮肤病变部位（颈部、乳房和前躯干）。2例患者中皮肤是主要病变部位，而其余患者的分期检查显示为全身性淋巴瘤。每位患者的组织学表现均为典型的淋巴母细胞淋巴瘤；肿瘤细胞小，核染色质呈母细胞样。3例患者的肿瘤细胞呈卷曲状，3例则为非卷曲状。免疫表型分析显示，4例淋巴瘤为前B细胞型，2例淋巴瘤为T细胞型。组织学特征与免疫表型之间无相关性。由于大多数淋巴母细胞淋巴瘤为T细胞型，累及皮肤的前B细胞肿瘤占优势可能提示前B细胞肿瘤易累及皮肤。为进一步支持这一假说，2例似乎起源于皮肤的淋巴瘤均具有前B细胞免疫表型。
