Kiniwa Yukiko, Ide Yoko, Fukushima Mana, Asano Naoko, Saida Toshiaki
Department of Dermatology, Shinshu University School of Medicine, Nagano 390-8621, Japan.
J Cutan Pathol. 2011 Jan;38(1):38-42. doi: 10.1111/j.1600-0560.2009.01486.x.
We report a unique case of the CD30+ anaplastic large cell lymphoma (ALCL). A 44-year-old Japanese male presented with lymphadenopathy followed by skin involvement. Initially, a swollen cervical lymph node was recognized in 1989 and relapsed in 1991, which was histologically diagnosed as Hodgkin disease of nodular sclerotic type. In 1996, he presented ulcerative cutaneous nodules and swollen lymph nodes in his left inguinal region, which was then diagnosed with CD30+ ALCL. Both the lymphadenopathy and the skin lesion had been completely remitted by combining chemotherapy followed by radiotherapy. Thereafter, he had relapsing and remitting episodes of multiple papules and nodules on his face, trunk and extremities for 10 years. Repeated histopathological examination revealed similar tumor cell proliferation in the papules/nodules of the skin. Essentially similar immunohistochemical features, including CD30 and granzyme B expression, but not anaplastic lymphoma kinase (ALK), strongly suggested that all these tumors were sequential expression of one disease continued for 19 years. This case was finally diagnosed as CD30+ ALCL with unique skin involvement mimicking lymphomatoid papulosis (LyP).
我们报告了一例独特的CD30 + 间变性大细胞淋巴瘤（ALCL）病例。一名44岁的日本男性出现淋巴结病，随后累及皮肤。最初，1989年发现颈部淋巴结肿大，1991年复发，组织学诊断为结节硬化型霍奇金病。1996年，他左侧腹股沟区出现溃疡性皮肤结节和肿大淋巴结，随后被诊断为CD30 + ALCL。通过化疗联合放疗，淋巴结病和皮肤病变均完全缓解。此后，他面部、躯干和四肢反复出现丘疹和结节，呈复发和缓解状态，持续了10年。反复的组织病理学检查显示皮肤丘疹/结节中存在相似的肿瘤细胞增殖。本质上相似的免疫组化特征，包括CD30和颗粒酶B表达，但无间变性淋巴瘤激酶（ALK）表达，强烈提示所有这些肿瘤是一种持续19年疾病的连续表现。该病例最终被诊断为CD30 + ALCL，伴有类似淋巴瘤样丘疹病（LyP）的独特皮肤受累表现。
