右大腿部腫瘤より診断されたALK陽性 anaplastic large cell lymphoma の1例  [in Japanese] A case of ALK-positive anaplastic large cell lymphoma diagnosed from a nodule on the right thigh  [in Japanese]

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28歳,女。初診2週間前より右大腿内側に紅色結節が出現,増大するため当科を受診した。初診時,表面に僅かに鱗屑を伴う1×2cm大の紅色結節を認めた。皮膚生検にてCD30・ALK陽性の大型異型リンパ球の増殖を認め,anaplastic large cell lymphoma(ALCL)と診断し,全摘出術を施行した。同時に施行した右鼠径リンパ節生検では,辺縁洞と近傍のリンパ管内に腫瘍細胞を認め,皮膚病変からの所属リンパ節転移を思わせる所見であった。FDG-PETにて右腸骨領域のリンパ節に集積を認めた。以上よりALK陽性皮膚原発性ALCLと診断し,CHOP療法を8コース施行した。3コース終了の時点でPET上,異常集積は消失し,その後12ヵ月完全寛解を維持している。

A 28-year-old Japanese female noticed a slowly enlarging, red nodule on her right thigh about 2 weeks before her initial visit to our department. Clinical examination revealed a 1×2-cm-sized red nodule on her right medial thigh. Histologically, a dense and diffuse infiltration of CD30 and ALK-positive atypical cells was observed from the upper dermis to the subcutaneous tissue. We resected the entire tumor and her swollen right inguinal lymph node. The histology revealed tumor cells in the lymph sinuses and afferent lymphatics. FDG-PET disclosed a right intrailiac lesion, which prompted us to diagnose her condition as primary cutaneous ALCL with metastasis to the right inguinal lymph node and intrailiac area. Following this diagnosis, the patient was administered 8 courses of CHOP regimen although the right intrailiac lesion was no longer visible in the PET imaging after the initial 3 courses. The patient has remained in complete remission for 12 months.[<i>Skin Cancer (Japan)</i> 2010 ; 25 : 157-161]

Journal

  • Skin Cancer

    Skin Cancer 25(2), 157-161, 2010-09-15

    The Japanese Skin Cancer Society

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