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一般化的红色皮肤结节.
Laniyati Hamijoyo1, Dinar F Yaddin, Indra Wijaya
1Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, Indonesia. hamijoyo@yahoo.com.
Acta medica Indonesiana
|July 31, 2023
概括
诊断疼痛,深红色的皮肤结节可能是具有挑战性的. 这一案例凸显了皮肤扩散大B细胞淋巴瘤 (DLBCL) 作为差异诊断中的罕见但关键考虑因素.
科学领域:
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 结节性红色皮肤病变是一个具有广泛差异诊断的诊断挑战.
- 结节性红斑是一种常见的考虑因素,但彻底的检查对于准确的诊断至关重要.
- 皮肤淋巴瘤,特别是扩散性大B细胞淋巴瘤 (DLBCL),是罕见的,但对于不明原因的皮肤结节的重要考虑因素.
研究的目的:
- 呈现一种皮肤扩散大B细胞淋巴瘤 (DLBCL) 的病例,呈现为痛苦的,深红色的皮肤结节.
- 强调组织病理学和免疫组织化学在诊断罕见皮肤淋巴瘤方面的重要性.
- 突出DLBCL作为无法解释的红色皮肤结节的差异诊断.
主要方法:
- 一个60岁的女性的临床表现,疼痛,深红色的皮肤结节,发烧,关节痛和体重减轻.
- 实验室调查包括完整血清,肝功能测试和病毒抗原的血清测试.
- 组织病理学检查和免疫组织化学染色 (CD45,CD20,CD10,Ki67,CD3,CD56,CD30,Granzyme) 的皮肤结节活检.
主要成果:
- 组织病理学揭示了皮肤淋巴瘤,具有CD45,CD20,CD10和Ki67 (>70%) 的阳性免疫组织化学标志物.
- 该患者被诊断为皮肤扩散大B细胞淋巴瘤 (DLBCL).
- 在DLBCL中皮肤参与不常见,在呈现时仅发生3.3%的病例.
结论:
- 皮肤DLBCL可以呈现为非特异性的红色皮肤结节,需要高度的怀疑指数.
- 免疫组织化学对于区分皮肤淋巴瘤与其他皮肤疾病至关重要.
- 早期和准确的皮肤淋巴瘤诊断对于适当的管理和预后至关重要.
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