Primary cutaneous extra-nodal NK-cell lymphoma, nasal type

T. Terada
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Abstract

Primary extra-nodal NK-cell lymphoma of skin is extremely rare. A 55-year-old man presented with an elevated plaque of trunk. The dermatologists’ diagnosis was sporotrycosis and a biopsy was taken, which showed diffuse dense infiltrations of medium-sized and large atypical malignant lymphocytes. Epidermal hyperplasia and erosions were also seen. Immunohistochemically, the atypical lymphocytes were positive for CD45, CD56, CD57, p53 and Ki-67 (labeling index = 82%). They were negative for CD20, CD79, CD10, bcl-2, κ-light chain, λ-light chain, CD3, CD4, CD5, CD21, CD23, CD38, CD43, CD68, CD138, CD15, CD30, TdT, and cyclin D1. EBER was positive. The pathological diagnosis was primary cutaneous NK-cell lymphoma, nasal type. The post-biopsy blood test identified no leukemia findings. Post-biopsy imaginings revealed no mass and lymphadenopathy in the body. The skin lesions of the patient almost improved (complete remission) by chemotherapy (CHOP) followed by local radiation, and the patient is now followed up.
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原发性皮肤结外nk细胞淋巴瘤,鼻型
原发性皮肤结外nk细胞淋巴瘤极为罕见。55岁男性,躯干斑块升高。皮肤科医生诊断为孢子菌病,活检显示中、大型非典型恶性淋巴细胞弥漫性致密浸润。表皮增生及糜烂也可见。免疫组化结果显示,非典型淋巴细胞CD45、CD56、CD57、p53、Ki-67阳性(标记指数82%)。CD20、CD79、CD10、bcl-2、κ-轻链、λ-轻链、CD3、CD4、CD5、CD21、CD23、CD38、CD43、CD68、CD138、CD15、CD30、TdT、cyclin D1均阴性。希伯是肯定的。病理诊断为原发性皮肤nk细胞淋巴瘤,鼻型。活检后的血液检查未发现白血病。活检后影像学显示未见肿块和淋巴结病变。经化疗(CHOP)加局部放疗,患者皮肤病变基本改善(完全缓解),现予随访。
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