Marquart-Elbaz C, Lipsker D, Cribier B, Meyer M, Heid E
Clinique Dermatologique, des Hôpitaux Universitaires de Strasbourg.
Ann Dermatol Venereol. 1997;124(9):633-5.
Cutaneous B cell lymphomas, especially when appearing as a monomelic papulonodular eruption, are rare.
Ms H. 87-year-old, consulted for a papulonodular eruption of the left lower limb which developed during the past 5 months. This limb had been the site of a lymphedema since a traumatism 8 years ago. Histopathological analysis and immunostaining of a nodule showed that it was a large cell lymphoma of follicular stem cells. There was no extracutaneous involvement and the patient was successfully treated with radiotherapy. Two months after the completed radiotherapy a cutaneous relapse on the trunk and the upper limbs was treated with cyclophosphamide-vincristine-prednisone chemotherapy.
Lymphedema probably played a role in the genesis of this lymphoma presumably by reducing the local immune response. It may have harmed endothelial cells and maintained an antigenic stimulation leading first to lymphocyte hyperplasia and eventually to a true lymphoma, in the same way this has been proved for some MALT lymphomas.
皮肤B细胞淋巴瘤较为罕见，尤其是表现为单发性丘疹结节性皮疹时。
H女士，87岁，因左下肢丘疹结节性皮疹前来就诊，该皮疹在过去5个月内出现。自8年前外伤后，该肢体一直存在淋巴水肿。对一个结节进行组织病理学分析和免疫染色显示，这是一个滤泡干细胞大细胞淋巴瘤。无皮肤外受累情况，患者接受放疗后成功治愈。放疗结束两个月后，躯干和上肢出现皮肤复发，采用环磷酰胺-长春新碱-泼尼松化疗进行治疗。
淋巴水肿可能在该淋巴瘤的发生过程中起了作用，推测是通过降低局部免疫反应。它可能损害了内皮细胞并维持了抗原刺激，首先导致淋巴细胞增生，最终发展为真正的淋巴瘤，就像一些黏膜相关淋巴组织淋巴瘤已被证实的那样。
