Wang Xin, Li Wen-Sheng, Zheng Yan, Ying Zhao-Xia, Wang Yong-Xian, Wang Ying-Mei, Zheng Jun-Feng, Xiao Sheng-Xiang
Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China.
Department of Pathology, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710068, P.R. China.
Oncol Lett. 2016 May;11(5):3091-3096. doi: 10.3892/ol.2016.4352. Epub 2016 Mar 18.
The current study presents a case of cluster of differentiation (CD)56 myeloid sarcoma in a patient that initially presented with skin lesions, and provides evidence for the clinical and differential diagnosis of myeloid sarcoma. The patient of the present case report was a 65-year-old man who was admitted to hospital with a six-month history of bilateral purple-red papules and nodules, which were present on the upper limbs of the patient and had spread over his whole body one month prior to admission to the hospital. Pathological examination demonstrated a diffuse infusion of primitive round cells at the papillary dermis and subcutaneous tissues. The infiltrated cells were 40-60 µm in diameter and morphologically identical. Immunohistochemical examination revealed that the cells expressed myeloperoxidase, CD56, CD43 and T-cell intracytoplasmic antigen. In addition, several cells expressed CD34, and 90% of the cells expressed Ki67. While the majority of cells in myeloid sarcoma do not express CD56, the present case was a myeloid sarcoma that expressed CD56, which is extremely rare. The sarcoma in the present patient progressed rapidly, and the patient died eight months following the onset of disease. Clinicians should be aware of CD56 myeloid sarcoma, which is easily misdiagnosed and inappropriately treated. Consequently, myeloid sarcoma may have a high malignancy and poor outcome for patients.
本研究报告了一例最初表现为皮肤病变的分化簇(CD)56髓系肉瘤患者,并为髓系肉瘤的临床诊断和鉴别诊断提供了依据。本病例报告的患者为一名65岁男性,因双侧紫红色丘疹和结节病史6个月入院,这些皮疹出现在患者上肢,入院前1个月已蔓延至全身。病理检查显示乳头真皮和皮下组织有弥漫性原始圆形细胞浸润。浸润细胞直径为40 - 60μm,形态相同。免疫组化检查显示细胞表达髓过氧化物酶、CD56、CD43和T细胞胞浆内抗原。此外,部分细胞表达CD34,90%的细胞表达Ki67。虽然髓系肉瘤中的大多数细胞不表达CD56,但本病例是一例表达CD56的髓系肉瘤,极为罕见。本患者的肉瘤进展迅速,发病8个月后死亡。临床医生应认识到CD56髓系肉瘤,其容易被误诊和不恰当治疗。因此,髓系肉瘤对患者可能具有高恶性和不良预后。