皮膚原発blastic NK cell lymphoma : 1例報告と過去の報告例35例のまとめ  [in Japanese] Primary Cutaneous Blastic NK Cell Lymphoma : A Case Report With Review of the Literature  [in Japanese]

Access this Article

Author(s)

Abstract

Blastic NK cell lymphomaは近年NK cell lymphomaの1亜型として報告されるようになった疾患で,皮膚に好発することや非常に予後が悪いことが特徴的である.今回我々は,Blastic NK cell lymphomaと診断し,末梢血幹細胞移植を施行した1例を経験したので報告する.症例は31歳,男性.初診の5カ月前より背部に紅斑が出現,徐々に増大し腫瘤を形成.初診時,左背部に57 mm×47 mm×6 mm大のドーム状に隆起した骨様硬の紅色腫瘤と45 mm×26 mm大の浸潤を触れる紅色局面を認めた.病理組織学的には真皮上層から脂肪織にかけてびまん性に中~大型の幼弱な異型リンパ球が浸潤し,免疫染色にてCD4,CD56陽性,in situ hybridizationによるEBERは陰性であった.また,左腋窩リンパ節にも同様の細胞浸潤を認めた.Blastic NK cell lymphomaと診断し,多剤併用化学療法,電子線照射療法を行い完全寛解となったが予後の悪さを考慮して,弟からの末梢血幹細胞移植を施行した.16カ月経った現在まで再発,転移を認めていない.過去のblastic NK cell lymphomaの報告例では,末梢血幹細胞移植の施行例はほとんどないことから,貴重な症例と思われた.

We describe a 31-year-old-male case of primary cutaneous blastic NK cell lymphoma. He had a red tumor and an indurated erythema plaque on his back. Skin and lymph node biopsies revealed diffuse proliferation of medium-to large-sized lymphoblastic cells that were positive for CD4, CD45, CD45RA, CD56 and HLA-DR, and negative for CD2, CD3 (surface and cytoplasmic), CD5, CD30, CD57, and CD68.<i> In situ</i> hybridization for EB virus and Southern blot analysis of T cell and B cell receptor gene rearrangement were negative. Based on these results, we diagnosed this case as blastic NK cell lymphoma. After several courses of combination chemotherapy and electron beam irradiation followed by allogeneic peripheral blood stem cell transplantation, this case went into complete remission. We review previously published reports of blastic NK cell lymphoma.

Journal

  • The Japanese Journal of Dermatology

    The Japanese Journal of Dermatology 112(6), 829-836, 2002-05-20

    Japanese Dermatological Association

References:  27

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008880707
  • NII NACSIS-CAT ID (NCID)
    AN00196602
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0021499X
  • NDL Article ID
    025120558
  • NDL Call No.
    Z19-202
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
Page Top