Department of Dermatology, Loma Linda University Medical Center, Loma Linda, California, USA.
Dermatol Online J. 2023 Apr 15;29(2). doi: 10.5070/D329260772.
A 75-year-old man with a three-year history of metastatic lung adenocarcinoma was diagnosed with cutaneous lymphangitic carcinomatosa of unique morphology. He was admitted to our hospital for right neck swelling, erythema, and failure to thrive. Skin examination demonstrated an indurated, thickened, firm, hyperpigmented plaque extending from the right neck and chest to the right ear, cheek, and eyelids. Skin biopsy demonstrated poorly differentiated adenocarcinoma, morphologically consistent with metastasis from the patient's known pulmonary adenocarcinoma and showed dermal invasion, perineural invasion, and involvement of dermal lymphatics. The diagnosis was an atypical presentation of cutaneous lymphangitis carcinomatosa from metastatic lung adenocarcinoma. This case presentation affirms that cutaneous lymphangitis carcinomatosa has a variety of atypical presentations, so physicians must maintain a high index of suspicion when evaluating cutaneous lesions in patients with known or suspected internal malignancy.
一位 75 岁男性，患有三年转移性肺腺癌病史，被诊断为具有独特形态的皮肤淋巴管癌病。他因右侧颈部肿胀、红斑和消瘦入住我院。皮肤检查显示从右侧颈部和胸部延伸至右侧耳朵、脸颊和眼睑的硬结、增厚、坚硬、色素沉着斑块。皮肤活检显示低分化腺癌，形态上与患者已知的肺腺癌转移一致，并显示真皮浸润、神经周围浸润和真皮淋巴管受累。诊断为转移性肺腺癌的皮肤淋巴管癌病的非典型表现。本病例证实，皮肤淋巴管癌病有多种非典型表现，因此医生在评估已知或疑似有内脏恶性肿瘤的患者的皮肤病变时，必须保持高度怀疑。
