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CD8 阳性原发性皮肤间变性大 T 细胞淋巴瘤(PCALCL):病例报告及对这种不寻常 PCALCL 变体的综述

CD8-positive primary cutaneous anaplastic large T-cell lymphoma (PCALCL): case report and review of this unusual variant of PCALCL.

作者信息

Plaza Jose A, Ortega Pablo, Lynott James, Mullane Michael, Kroft Steve, Olteanu Horatiu

机构信息

Department of Dermatopathology, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Am J Dermatopathol. 2010 Jul;32(5):489-91. doi: 10.1097/DAD.0b013e3181c57ec2.

Abstract

Primary cutaneous anaplastic large T-cell lymphoma (PCALCL) is a well-defined CD30-positive lymphoproliferative disorder with relatively good prognosis and response to treatment. We describe a case of PCALCL expressing CD8. The patient is a 57-year-old man that clinically presented with an ulcerated nodule in his left middle finger. Histopathologic sections showed an ulcerated epidermis with a diffuse lymphocytic infiltrate in the superficial dermis with focal epidermotropism. The large cohesive atypical cells were admixed with a reactive infiltrate composed of neutrophils, eosinophils, and small lymphocytes. Immunohistochemical studies showed the tumor cells to be strongly positive for CD8, CD30, and TIA-1, focally positive for CD3, and negative for CD4, CD20, CD56, Anaplastic Lymphoma Kinase (ALK-1), and HSV. Epstein-Barr virus by in situ hybridization was negative. The diagnosis of a CD8+ PCALCL was confirmed. There is limited precedent literature regarding CD8-positive PCALCL and this case falls within the clinical and histopathologic spectrum of CD30+ lymphoproliferative disorders. CD8/CD30 coexpression is rare in PCALCL and may have important clinical and prognostic implications. To the best of our knowledge there are only 4 previously reported cases describing similar findings.

摘要

原发性皮肤间变性大T细胞淋巴瘤(PCALCL)是一种明确的CD30阳性淋巴增殖性疾病,预后相对较好,对治疗反应良好。我们描述了一例表达CD8的PCALCL病例。患者为一名57岁男性,临床上表现为左手中指出现一个溃疡结节。组织病理学切片显示表皮溃疡,浅层真皮有弥漫性淋巴细胞浸润,并伴有局灶性亲表皮现象。大的聚集性非典型细胞与由中性粒细胞、嗜酸性粒细胞和小淋巴细胞组成的反应性浸润混合存在。免疫组织化学研究显示肿瘤细胞CD8、CD30和TIA-1呈强阳性,CD3局灶性阳性,CD4、CD20、CD56、间变性淋巴瘤激酶(ALK-1)和单纯疱疹病毒(HSV)呈阴性。原位杂交检测爱泼斯坦-巴尔病毒为阴性。CD8+ PCALCL的诊断得到证实。关于CD8阳性PCALCL的先例文献有限,该病例属于CD30+淋巴增殖性疾病的临床和组织病理学范畴。CD8/CD30共表达在PCALCL中罕见,可能具有重要的临床和预后意义。据我们所知,此前仅有4例报道描述了类似的发现。

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