皮膚浸潤を生じた Follicular Lymphoma の1例  [in Japanese] A Case of Follicular Lymphoma with Cutaneous Infiltration  [in Japanese]

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Abstract

卵巣腫瘍があり手術予定であった62歳の女性。骨盤腹腔内,左肺門,両側腋窩,左鎖骨上部,両側頚部リンパ節腫脹のほか顔面,頚部,背部に浸潤を触れる紅斑を認めた。背部の皮疹の病理組織像は,核異型性の強い小型から大型のCD20(+)単核細胞が真皮に結節性に浸潤しておりB-cell lymphomaが疑われた。摘出された腹腔リンパ節では,CD3(-), CD20(+), CD10(+), CD5(-)で濾胞構築を示す大型の単核細胞が腫瘍性増殖しており,follicular lymphoma(FL)と診断した。卵巣はmucinous cystadenoma, endocervical typeのほか,リンパ節と同様の大型細胞の浸潤がみられたが,濾胞構造を示す箇所は一部で多くはびまん性に浸潤していた。なお,bcl-2タンパクの発現は皮膚のみで陽性だった。二次浸潤臓器での病理組織型とbcl-2タンパクの発現について検討した。

A 62-year old woman with an ovarian tumor presented with indulated erythemas on her face, neck and back. A skin biopsy from a lesion on her back showed dense and nodular infiltrate of atypical mononucleocytes throughout the dermis. She underwent operation for the removal of the ovarian tumor and her pelvic and para-aorta lymph nodes. A histological examination of her para-aorta lymph node resulted in a diagnosis of follicular lymphoma (FL) of large cell type. Her ovaries also demonstrated a diffnse imfiltration of lymphoma cells in addition to the mucinous cystadenoma, endocervical type. These lymphoma cells showed CD3(-), CD10(+), CD20(+), CD5(-). Bcl-2 oncoprotein was only positive, however, at the cutaneous site. We discuss the prognostic factors of FL in association with both the histologic transformation into a diffuse pattern and the expression of bcl-2 protein in the secondary infiltrating lesions.

Journal

  • The Nishinihon Jourrnal of Dermatology  

    The Nishinihon Jourrnal of Dermatology 64(2), 194-199, 2002-04-01 

    Western Division of Japanese Dermatological Association

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