中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (4): 279-282.doi: 10.12144/zgmfskin202504279

• 临床研究 • 上一篇    下一篇

表现为环状肉芽肿的原发性皮肤弥漫性大B细胞淋巴瘤-腿型一例并文献复习

陈伟权,黄敬然,王蕾,方零露,周英   

  1. 广东医科大学附属医院皮肤性病研究所，广东湛江，524000
  • 出版日期:2025-04-15 发布日期:2025-04-08

Primary cutaneous diffuse large B-cell lymphoma, leg type, presenting as annular granuloma: a case report and literature review

CHEN Weiquan, HUANG Jingran, WANG Lei, FANG Linglu, ZHOU Ying   

  1. Institute of Dermatology and Venereal Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China
  • Online:2025-04-15 Published:2025-04-08

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摘要： 原发性皮肤弥漫性大B细胞淋巴瘤-腿型（PCDLBCL-LT）是一种罕见的皮肤B细胞淋巴瘤，具有较高的侵袭性和复发风险，本文报道一例。患者，男，47岁，右侧腰部环状红斑1个月。组织病理示大量异型淋巴细胞浸润，免疫组化CD20、CD79a、Bcl-2阳性，Ki-67增殖指数达80%。患者接受R-CHOP方案化疗五程后，皮损完全消退，随访2年半未见复发。本病例提示PCDLBCL-LT可能以环状肉芽肿样皮损为表现，易误诊，需结合病理和免疫组化确诊，并及时进行系统治疗以改善预后。

关键词: 弥漫性大B细胞淋巴瘤, 腿型, 环状, 利妥昔单抗

Abstract: Primary cutaneous diffuse large B-cell lymphoma-leg type (PCDLBCL-LT) is a rare form of skin B-cell lymphoma with a high risk of aggression and recurrence. We report a 47-year-old male with erythema annularis on the right lumbar for 1 month. Pathology showed a large number of heterogeneous lymphocyte infiltrates in the lesion, immunohistochemical CD20, CD79a, Bcl-2 positive, Ki-67 proliferation index up to 80%. After five courses of chemotherapy with R-CHOP regimen, the skin lesions completely subsided, and no recurrence was observed during the follow-up of two and a half years. This case suggests that PCDLBCL-LT may be manifested as annular granulomatous lesions, which is easy to misdiagnose. It is necessary to confirm the diagnosis by combining pathology and immunohistochemistry, and timely systematic treatment to improve the prognosis.

Key words: primary cutaneous diffuse large B-cell lymphoma, leg type, annular, rituximab