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一例复发性脓肿样病变的疑难病例:对原发性皮肤弥漫性大B细胞淋巴瘤,腿部型的见解

A Perplexing Case of Recurrent Abscess-Like Lesions: Insights Into Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type.

作者信息

Bin Waqar Syed Hamza, Zaman Unaiza, Salahi Navid, Gupta Raavi, McFarlane Isabel M

机构信息

Internal Medicine, State University of New York Downstate Medical Center, New York, USA.

Pathology, State University of New York Downstate Medical Center, New York, USA.

出版信息

Cureus. 2021 Sep 6;13(9):e17766. doi: 10.7759/cureus.17766. eCollection 2021 Sep.

DOI:10.7759/cureus.17766
PMID:34659977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8494052/
Abstract

Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) is one of the rarest forms of primary cutaneous lymphomas (PCLs) and it confers a poor prognosis. Diagnosis of PCDLBCL-LT can be challenging and complex as it can manifest with a myriad of dermatological presentations. However, early treatment with chemo-radiation leads to an appropriate response. We present the case of a 66-year-old female with a history of polymyositis and interstitial lung disease on immunosuppression who presented to our institution with recurrent abscess-like lesions localized to buttocks that were later biopsied and diagnosed as the leg-type variant of PCL. She received chemotherapy with the rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen and subsequent involved-site radiation therapy (ISRT), which resulted in complete remission. The patient was later followed up and remained in remission for years.

摘要

原发性皮肤弥漫性大B细胞淋巴瘤,腿部型(PCDLBCL-LT)是原发性皮肤淋巴瘤(PCL)中最罕见的形式之一,预后较差。PCDLBCL-LT的诊断具有挑战性且复杂,因为它可表现为多种皮肤病学表现。然而,早期进行放化疗可带来适当的反应。我们报告一例66岁女性病例,该患者有皮肌炎和间质性肺病病史,正在接受免疫抑制治疗,因臀部反复出现脓肿样病变前来我院就诊,这些病变后来经活检被诊断为腿部型PCL。她接受了利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松(R-CHOP)方案的化疗以及随后的受累部位放射治疗(ISRT),结果实现了完全缓解。该患者随后接受随访,多年来一直处于缓解状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/376e/8494052/172f47849b03/cureus-0013-00000017766-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/376e/8494052/172f47849b03/cureus-0013-00000017766-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/376e/8494052/172f47849b03/cureus-0013-00000017766-i01.jpg

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Primary Cutaneous B-Cell Lymphomas: An Update.原发性皮肤B细胞淋巴瘤:最新进展
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Multiple genetic alterations in primary cutaneous large B-cell lymphoma, leg type support a common lymphomagenesis with activated B-cell-like diffuse large B-cell lymphoma.原发性皮肤弥漫大 B 细胞淋巴瘤,腿型中的多种基因改变支持与活化 B 细胞样弥漫大 B 细胞淋巴瘤共同的淋巴瘤发生机制。
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