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題 名 | 合併皮膚侵犯之原發性全身性退行發育細胞淋巴瘤--病例報告=Primary Systemic Anaplastic Large Cell Lymphoma with Skin Involvement--A Case Report |
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作 者 | 林尚志; 洪克明; 張明志; 溫素瑩; | 書刊名 | 中華皮膚科醫學雜誌 |
卷 期 | 21:4 2003.12[民92.12] |
頁 次 | 頁367-374 |
分類號 | 415.789 |
關鍵詞 | 皮膚侵犯; 退行發育細胞淋巴瘤; Anaplastic large cell lymphoma; Anaplastic lymphoma kinase; CD30; |
語 文 | 中文(Chinese) |
中文摘要 | 退行發育大細胞淋巴瘤是一種少見的疾病;相較於表現出ALK融合蛋白質的原發性全身性ALCL病例,原發性全身性ALCL不表現出ALK融合蛋白質的病例對於化學治療有較差的反應以及較差的預後,吾人報告一位93歲男性患者,大約半個月前,在左側鎖骨上部位發現三個暗紅色小丘疹以及在左側胸壁皮膚一個迅速長大的腫塊。組織病理學檢查顯示真皮層廣泛地浸潤著數種淋巴細胞,這些淋巴細胞包括小淋巴球以及大而退行發育的腫瘤細胞。免疫組織化學檢查顯示這些腫瘤細胞對CD30染色呈陽性,而對CD3、CD4、CD5、CD15、CD20、CD56、ALK染色呈陰性。腹部電腦斷層掃瞄及鎵67核子醫學檢查顯示右側鎖骨部位淋巴結、胸部縱膈腔及脾臟有淋巴瘤侵犯。我們診斷這是一例合併皮膚侵犯之原發性全身性退行發育淋巴瘤激脢陰性退行發育大細胞淋巴瘤。病患接受多重化學治療,治療至今7個月,目前處於部分緩解狀態,腫瘤消失75%並繼續門診追蹤治療。 |
英文摘要 | Anaplastic large cell lymphoma(ALCL) is a rare non-Hodgkin’s lymphoma. Primary systemic anaplastic lymphoma kinase-negative (ALK-) ALCL has a poor response to chemotherapy and an unfavorable prognosis in contrast with primary systemic ALK+ ALCL. We report a 93-year-old man presented with three dusky erythematous papules on left supraclavicular area and a rapidly enlarging erythematous tumor on left chest wall for about half a month. The histopathological examination showed a patchy and nodular infiltrate of a mixed population of lymphoid cells ranging from reactive small lymphoid cells to large anaplastic cells in the dermis and subcutis. The immunohistochemical study revealed positivity of neoplastic cells for CD30 antigen and negativities for CD3、CD4、CD5、CD15、CD20、CD56、ALK antigens. Abdominal CT scan and gallium – 67 whole body scan showed involvement of right c1aviclar lymph nodes, mediastinum and spleen. Based on the clinicopathological and immunohistochemical findings, a diagnosis of primary systemic anaplastic lymphoma kinase-negative ALCL with skin involvement was made. He was treated with polychemotherapy and partial remission was achieved. We hereby report this case and review the literature. |
本系統中英文摘要資訊取自各篇刊載內容。