[1]白艳玲,宋智琦.皮肌炎并发皮肤弥漫大B细胞淋巴瘤1例[J].中国皮肤性病学杂志,2015,(07):712-714.[doi:10.13735/j.cjdv.1001-7089.201407077]
 BAI Yan ling,SONG Zhi qi.A Case of Dermatomyositis Complicated with Skin Diffuse Large B Cell Lymphoma[J].The Chinese Journal of Dermatovenereology,2015,(07):712-714.[doi:10.13735/j.cjdv.1001-7089.201407077]
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皮肌炎并发皮肤弥漫大B细胞淋巴瘤1例
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2015年07期
页码:
712-714
栏目:
病例报告
出版日期:
2015-07-01

文章信息/Info

Title:
A Case of Dermatomyositis Complicated with Skin Diffuse Large B Cell Lymphoma
作者:
白艳玲宋智琦
大连医科大学附属第一医院皮肤科,辽宁 大连 116011
Author(s):
BAI YanlingSONG Zhiqi
Department of Dermatology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China
关键词:
弥漫大B细胞淋巴瘤皮肌炎
Keywords:
Diffuse large B cell lymphomaDermatomyositis
分类号:
R 593.26;R 739.5
DOI:
10.13735/j.cjdv.1001-7089.201407077
文献标志码:
B
摘要:
患者男,55岁。8个月前出现双眼眶周围水肿性暗红紫色斑,双手、双足、双腕,双肘伸侧出现稍高于皮肤的红色鳞屑性皮疹。于3个半月前在四川大学华西医院经过肌电图、皮肤活检、肌肉活检等检查明确诊断为皮肌炎。出院后右颈部出现黄豆大小肿物,渐变大成直径约5cm无痛性圆盘形肿物,表面中心破溃、坏死、结黑痂。就诊于本科门诊行皮肌炎生化:LDH 354 U/L,CK 22 U/L,CKMB 1.7μg/L。癌胚抗原示:CEA 3.28 ng/mL、细胞角蛋白19片段2.63 ng/mL,NES 12.61 ng/mL,皮损组织病理示:真皮内弥漫性淋巴组织样细胞、浆细胞样细胞浸润。免疫组化示:CD20弥漫(+),CD3(-),CD21(-),CD30(-),CD43(+),CD10(-),CD5(-),Bc12(+),Bc16(+),MUMl (+),EBER弥漫(+),为EB病毒阳性弥漫大B细胞淋巴瘤。胸部CT示:右肺上叶和下叶后背段;左肺下叶内侧基底段见毛玻璃样结节。诊断:弥漫大B细胞淋巴瘤;皮肌炎。皮肌炎的皮下结节有并发弥漫大B细胞淋巴瘤的可能,应行组织病理检查予以排除。
Abstract:
A 55year old male presented with edema and dark purple patch on bilateral peripheral orbita,and red scaly rash slightly higher than the skin showed on his hands,feet, elbows extended side.The EMG,skin biopsy and muscle biopsy findings were consistent with dermatomyositis in West China Hospital of Sichuan University about 3 and a half months ago.After discharge,a mass with bean size appeared on the right neck of the patient,which progressed to 5cm painless and disc type tumor,with ulceration,necrosis and blackscab in the center of the surface.Admitted to outpatient department of First Affiliated Hospital of Dalian Medical University,results of biochemical dermatomyositis revealed LDH 354U/L,CK 22U/L, CKMB 1.7μg/L.Carcinoembryonic antigen showed CEA 3.28 ng/mL,cytokeratin 19 fragment of 2.63 ng/mL,NES 12.61 ng/mL.Histopathological examination indicated diffuse lymphoidcells and plasmacytoid cells infiltration in dermis.Immunohistochemistry showed:diffuse CD20 (+),CD3(-),CD21(-),CD30(-),CD43 (+),CD10(-),CD5(-),Bc12 (+),Bc16 (+),MUM 1(+),EBER (+),diffuse EB virus positive diffuse large B cell lymphoma.Chest CT showed ground glass density nodules on right upper lobe of lung after dorsal segment of lower lobe,the next page medial basal segment of the left lung.A diagnosis of diffuse large B cell lymphoma;dermatomyositis was made.Subcutaneous nodules of dermatomyositis dermatomyositis may complicate with diffuse large B cell lymphoma and biopsy should be made toto exclude the possibility

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更新日期/Last Update: 2015-07-25