Khalifeh Ibrahim, Hughey Lauren C, Huang Conway C, Reddy Vishnu V B, Sellheyer Klaus
Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Cutan Pathol. 2009 Oct;36 Suppl 1:80-5. doi: 10.1111/j.1600-0560.2009.01227.x.
Cutaneous Hodgkin lymphoma is infrequent and typically occurs after extensive involvement of the lymph nodes. The condition decreased significantly in incidence in the past two decades, likely owing to the new treatment protocols composed of chemotherapy, radiotherapy and stem cell transplantation. Nevertheless, recognition of this uncommon but significant disease manifestation is important from a prognostic and therapeutic perspective. We are sharing a recent case of Hodgkin lymphoma where the primary presentation appeared as a solitary plaque on the left side of the occipital scalp, clinically suspected to represent a ruptured follicular cyst. The patient underwent excisional biopsy. Histological assessment revealed Hodgkin lymphoma affecting the skin. Radiological studies showed no regional lymphadenopathy. However, two enlarged lymph nodes were identified in the mediastinum and were positron emission tomography avid. The patient underwent systemic treatment without further histopathological examination of these two lymph nodes. Not being clear if these enlarged two lymph nodes were related to his cutaneous disease or not, we cannot be sure if the patient was afflicted either by primary cutaneous Hodgkin lymphoma or by secondary cutaneous involvement because of hematogenous spread. In either case, primary or secondary cutaneous Hodgkin disease is an extreme rarity. The literature is critically reviewed.
皮肤型霍奇金淋巴瘤较为罕见，通常在淋巴结广泛受累后出现。在过去二十年中，该疾病的发病率显著下降，这可能归因于由化疗、放疗和干细胞移植组成的新治疗方案。然而，从预后和治疗的角度来看，认识这种罕见但重要的疾病表现很重要。我们分享一个近期的霍奇金淋巴瘤病例，其最初表现为枕部头皮左侧的一个孤立斑块，临床上怀疑是破裂的滤泡囊肿。患者接受了切除活检。组织学评估显示为皮肤型霍奇金淋巴瘤。影像学检查未发现区域淋巴结肿大。然而，在纵隔中发现了两个肿大的淋巴结，并且正电子发射断层扫描显示其摄取活跃。患者未对这两个淋巴结进行进一步的组织病理学检查就接受了全身治疗。由于不清楚这两个肿大的淋巴结是否与他的皮肤疾病有关，我们无法确定该患者是患有原发性皮肤型霍奇金淋巴瘤还是由于血行播散导致的继发性皮肤受累。无论哪种情况，原发性或继发性皮肤型霍奇金病都极为罕见。本文对相关文献进行了批判性综述。
