摘要
OBJECTIVE: To examine 10 cases with primary cutaneous CD30-positive anaplastic large cell lymphoma (ALCL), analyze their clinical manifestations and pathological and immunohistochemical features, and improve early diagnosis of this disease. METHODS: We studied the morphological characteristics of primary cutaneous CD30-positive ALCL using histopathological methods. Leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelial membrane antigen (EMA), cytokeratin (CK) and HMB45 antibodies were used to determine the expression of their respective antigens from routine paraffin samples of the patients. RESULTS: Ten patients (7 men and 3 women, aged 31 to 84 years) complained of subcutaneous masses or papular eruptions over their lower trunks and extremities. Histopathologically, the lesions were composed of numerous large round or oval pleomorphic cells. The cytoplasm was usually abundant, amphophilic or basophilic, and finely vacuolated. Nuclei were commonly eccentrically localized and lobated or horseshoed in shape, and multinucleated giant cells and Reed-Sternberg-like cells were seen. Nucleoli were generally multiple and large. Of the 10 patients, tumor cells displayed positive antigen expression of CD30 in all cases, positive CD45RO in 6 cases, positive CD20 in only 1 case, but negative CD45RO and CD20 expressions in 3 cases. Two patients died at 7 weeks and 3.4 years of follow-up, respectively. CONCLUSION: Our study highlights the importance of histopathologic features and positive CD30 staining for differentiation of this disease from other malignant skin tumors.
目的 对 10例皮肤原发性CD30阳性间变性大细胞淋巴瘤 (ALCL)进行临床及组织病理学研究 ,为临床病理早期诊断提供依据。方法 采用组织病理学及免疫组织化学法 (LCA、CD2 0、CD30、CD4 5RO、CD68、EMA、CK和HMB4 5 )对 10例皮肤原发性CD30阳性ALCL进行观察。结果 组织病理学示瘤细胞体积大 ,呈多形性、圆形或椭圆形 ,胞浆丰富 ,核大 ,核分裂像多 ,常见R S样细胞和多核巨细胞 ,核仁明显。免疫组化标记CD30阳性 ,其中 6例同时表达CD4 5RO ,1例表达CD2 0 ,非T非B表达 3例。随访发现 2例因肿瘤转移死亡 ,2例复发 ,6例无复发。结论 皮肤原发性CD30阳性ALCL是具有独特形态特点且预后较好的肿瘤。
