Lü Zheng, Shi Yuan-kai, He Xiao-hui, Qin Yan, Zhou Sheng-yu, Zhang Chang-gong, Liu Peng, Yang Jian-liang
Department of Medical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2010 May 11;90(18):1247-50.
To explore the clinical presentation, therapy and prognosis study of primary cutaneous anaplastic large cell lymphoma (PCALCL).
We reviewed and analyzed ten cases of PCALCL receiving treatment at our hospital from January 1999 to January 2009.
There were 8 males and 2 females with a median age of 48 years old (range: 22 - 69). There were single subcutaneous nodule (n = 7) and multiple nodules (n = 3). And the lesions could be found on head and neck (n = 5), trunk (n = 3) and all over body (n = 2). The lesions appeared red, solid and stable subcutaneous nodules. Partial lesions had a spontaneous regression and new nodules appeared at the same or different sites. Two patients had lymphadenopathy and one had bone involvement with anaplastic lymphoma kinase (ALK) positive and high cell proliferation ratio index (ki-67 > 80%). Seven cases with single lesion received surgical excision plus radiotherapy, chemotherapy or radiochemotherapy, one case recurred, six cases survived without disease. Three cases with multiple lesions received systemic chemotherapy mainly in combination with radiotherapy or biotherapy, two cases recurred and one case survived without disease. The median follow-up was 44 months (range: 9 - 95), progression free survival 89% and overall survival 100%.
PCALCL is found more commonly in males. Visceral and lymph node involvement are rare. The patients with single lesion have a longer disease-free survival than those with multiple lesions after surgical excision in combination with chemotherapy or radiotherapy. Multiple lesions can not be cured.
探讨原发性皮肤间变性大细胞淋巴瘤(PCALCL)的临床表现、治疗方法及预后。
回顾分析我院1999年1月至2009年1月收治的10例PCALCL患者的临床资料。
男性8例,女性2例,中位年龄48岁(22 - 69岁)。表现为单个皮下结节7例,多个结节3例。皮损部位为头颈部5例,躯干3例,全身2例。皮损表现为红色、实性、稳定的皮下结节。部分皮损可自行消退,同时或其他部位出现新结节。2例有淋巴结肿大,1例有骨受累,间变性淋巴瘤激酶(ALK)阳性,细胞增殖率指数高(ki-67>80%)。7例单发病变患者行手术切除加放疗、化疗或放化疗,1例复发,6例无病生存。3例多发病变患者主要行全身化疗,联合放疗或生物治疗,2例复发,1例无病生存。中位随访时间44个月(9 - 95个月),无进展生存率89%,总生存率100%。
PCALCL男性多见,内脏及淋巴结受累少见。单发病变患者手术切除联合化疗或放疗后无病生存期长于多发病变患者。多发病变难以治愈。