Wikholm Colin G, Thakker Sach, Bakhshi Pegah R, Swigost Adam J, Moshell Alan, Cardis Michael A
Department of Dermatology MedStar Washington Hospital Center / Georgetown University Hospital Washington Columbia USA.
Georgetown University School of Medicine Washington Columbia USA.
Skin Health Dis. 2023 Aug 7;3(5):e277. doi: 10.1002/ski2.277. eCollection 2023 Oct.
Herein we present case report of a 73-year-old female who developed a rapidly growing, ulcerated lesion on her left superior eyelid. Despite treatment for suspected infection, symptoms only marginally improved. Physical examination revealed a diffusely ulcerated multinodular tumour with overlying haemorrhagic and serosanguineous exudate. A shave biopsy led to a diagnosis of primary cutaneous anaplastic large cell lymphoma (pcALCL), a rare CD30+ lymphoproliferative disorder. The patient had no extracutaneous involvement on PET-CT and her prognosis is good given the indolent nature of pcALCL. Differential diagnoses included merkel cell carcinoma, periocular sebaceous carcinoma, lymphomatoid papulosis, and extranodal natural killer/T cell lymphoma. Prognosis for pcALCL is generally good. Treatment recommendation for pcALCL is surgical excision with negative margins for localised disease, while intravenous brentuximab vedotin is suggested for widespread, relapsed, and refractory disease.
在此,我们报告一例73岁女性病例,其左上眼睑出现一个迅速生长的溃疡性病变。尽管对疑似感染进行了治疗,但症状仅略有改善。体格检查发现一个弥漫性溃疡的多结节肿瘤,表面有出血性和血清血性渗出物。剃除活检诊断为原发性皮肤间变性大细胞淋巴瘤(pcALCL),这是一种罕见的CD30 +淋巴增殖性疾病。患者PET-CT检查无皮肤外受累,鉴于pcALCL的惰性性质,其预后良好。鉴别诊断包括默克尔细胞癌、眼周皮脂腺癌、淋巴瘤样丘疹病和结外自然杀伤/T细胞淋巴瘤。pcALCL的预后通常良好。pcALCL的治疗建议是,对于局限性疾病采用手术切除且切缘阴性,而对于广泛、复发和难治性疾病,建议使用静脉注射本妥昔单抗。