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皮肤淋巴细胞瘤(皮肤 B 细胞假性淋巴瘤):102 例研究,重点在于粟粒样型的组织学特征和免疫组织化学。

Lymphocytoma cutis (cutaneous B-cell pseudolymphoma): study of 102 cases with emphasis on the histological characteristics and immunohistochemistry of the miliarial type.

机构信息

Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México.

Departamento de Histopatología, Instituto Dermatológico de Jalisco, "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México.

出版信息

Int J Dermatol. 2022 Mar;61(3):316-323. doi: 10.1111/ijd.15909. Epub 2021 Sep 19.

Abstract

BACKGROUND

Lymphocytoma cutis (LC) is a benign reactive lymphoproliferative B-cell process. It has two variants: localized type with solitary lesions and miliarial type with numerous lesions. The objective was to investigate the characteristics of LC with emphasis on the miliarial type.

METHODS

Retrospective study, patients with clinical and histopathological diagnosis of LC were included. Age, sex, evolution time, affected site, and type of treatment were investigated. In miliarial-type LC, the histological and immunohistochemical characteristics were also investigated.

RESULTS

In an 18-year period, there were 102 patients found with LC: 72 (71%) corresponded to females, the median age was 45 years, the median evolution time was 4 months, and the face was the most predominant affected area in 81 (79%) cases. Localized-type LC corresponded to 88 (86%) cases, and miliarial type in 14 (14%). The most common treatment was surgery, which was used in 32 (31%) patients, all of whom had localized type (P < 0.01). The most frequent treatment for miliarial-type LC was corticosteroids in five (36%, P = 0.32), the predominant histopathological pattern was nodular in 10 (71%) specimens, and immunohistochemistry was performed in 11 (79%), where all were positive for CD20 with polyclonality to kappa and lambda light chains.

CONCLUSIONS

The importance of LC lies in that it can be clinically and histopathologically confused with cutaneous lymphoma and that it is a rare entity, with its miliarial variant being rarer still. This study provides information on the clinical-histological characteristics of LC and its immunohistochemistry.

摘要

背景

皮肤淋巴细胞瘤(LC)是一种良性反应性 B 细胞淋巴增生性疾病。它有两种变体:局限性单一病变和粟粒性多发性病变。目的是研究 LC 的特征,重点关注粟粒性类型。

方法

回顾性研究,纳入临床和组织病理学诊断为 LC 的患者。调查了年龄、性别、演变时间、受累部位和治疗类型。在粟粒性 LC 中,还研究了组织学和免疫组织化学特征。

结果

在 18 年期间,共发现 102 例 LC 患者:72 例(71%)为女性,中位年龄为 45 岁,中位演变时间为 4 个月,81 例(79%)患者最常见的受累部位为面部。局限性 LC 占 88 例(86%),粟粒性占 14 例(14%)。最常见的治疗方法是手术,共 32 例(31%)患者接受了手术,均为局限性类型(P<0.01)。粟粒性 LC 最常见的治疗方法是皮质类固醇,共 5 例(36%),其中 10 例(71%)组织病理学模式为结节性,11 例(79%)进行了免疫组织化学检查,所有患者均为 CD20 阳性,κ 和 λ 轻链呈多克隆性。

结论

LC 的重要性在于它可以在临床上和组织病理学上与皮肤淋巴瘤混淆,而且它是一种罕见的实体,其粟粒性变体更为罕见。本研究提供了关于 LC 的临床-组织学特征及其免疫组织化学的信息。

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