Morris Taylor M, Mazzola Rosetta, Berry Brian, Sawyer Douglas, Saltman David L
Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
British Columbia Cancer Agency, 2410 Lee Avenue, Victoria, British Columbia, V8R 6 V5, Canada.
BMC Dermatol. 2015 Jul 23;15:11. doi: 10.1186/s12895-015-0032-z.
Small lymphocytic lymphoma is a relatively rare B-cell non-Hodgkin lymphoma that is considered to be the tissue equivalent of the much more common entity chronic lymphocytic leukemia. Cutaneous manifestations of small lymphocytic lymphoma are infrequent and the literature regarding them sparse. We describe here a case of a patient with a history of small lymphocytic lymphoma who developed perniosis-like features of the digits.
An 86-year old male patient with previously diagnosed small lymphocytic lymphoma developed painful erythematous swelling of the periungual area of his fingers and toes. This was associated with a dense dermal infiltration of CD5-positive B-lymphoid cells consistent with his low-grade B-cell lymphoma. Although partially refractory to local radiotherapy, the painful swelling of the fingers and toes resolved fully following systemic therapy with chlorambucil and rituximab.
This unusual cutaneous manifestation of a lymphoma and the favourable response to systemic therapy may be instructive for the management of other patients who develop similar perniosis-like features.
小淋巴细胞淋巴瘤是一种相对罕见的B细胞非霍奇金淋巴瘤,被认为是更为常见的慢性淋巴细胞白血病的组织等效物。小淋巴细胞淋巴瘤的皮肤表现并不常见,相关文献也较为稀少。我们在此描述一例有小淋巴细胞淋巴瘤病史的患者出现指端冻疮样表现的病例。
一名86岁男性患者,既往诊断为小淋巴细胞淋巴瘤,其手指和脚趾的甲周区域出现疼痛性红斑肿胀。这与CD5阳性B淋巴细胞的密集真皮浸润有关,符合其低度B细胞淋巴瘤。尽管局部放疗部分无效,但在使用苯丁酸氮芥和利妥昔单抗进行全身治疗后,手指和脚趾的疼痛性肿胀完全消退。
这种淋巴瘤不寻常的皮肤表现以及对全身治疗的良好反应可能对管理其他出现类似冻疮样表现的患者具有指导意义。