secondary cutaneous follicular center cell lymphoma
Introduction
Introduction to secondary skin follicular central cell lymphoma According to the US NCI statistics, there are 392 cases of FCCL in 1175 cases of NHL, accounting for 34%. It is more common. The Shanghai Lymphoma Cooperative Group reported 115 cases of 1771 cases of NHL (1972-198), accounting for only 6.5%. Less common, may be related to missed diagnosis, FCCL most often occurs in the lymph nodes, can also occur in the extranodal, such as the spleen, gastrointestinal tract, bone marrow, tonsils and skin, etc., occurs in the middle and old, males are slightly more common. About 4% of systemic FCCL is secondary to CML. Small cell cytoplasm is more common in FCCL, and 259 (68.2%) in 392 cases of NCI. Among the 115 cases of Shanghai lymphoma collaborative group, 55 cases (59.8%), followed by mixed cell type 22 cases (24%), large cell division 10 cases (11%), and non-cleaving cell type 5 cases (5.4%) . Although the large cell nature of FCCL is moderately malignant, it is generally low malignant. The small cell disease has a good prognosis, with a 5-year survival rate of 70% and a mixed cell and large cell 5-year survival rate of 50% and 45%, respectively. Secondary subtypes of secondary follicular central cell lymphoma, according to Burg statistics, centrocytic cells (CC), centroblastnic/centrocytic cells (CB/CC), and CB account for CML, respectively. 8%, 3% to 6%, and 2.5% to 4%. We have seen 18 cases, including 9 cases of CB/CC, 7 cases of CC, and 2 cases of CB. 1. Centrocytic lymphoma (centrocytic lymphoma) This disease, also known as lymphocytic lymphosarcoma (lymphocyticsarcoma), is a small nucleus follicular central cell malignant lymphoma (malignant lymphoma withs macrocleaved follicular center cells). 2. Centroblastic-centrocytic lymphoma (centroblastic-centrocytic lymphoma) This disease, also known as Brill-Symmer disease, has small nucleus and large non-lobed nucleus follicular central cell malignant lymphoma (malignantlyrephomawithsmallcleaved and large noncleavedfollicularcentereells), mixed small crack Nuclear and large cell malignant lymphoma (mixedsmallcleaved and largecellmalignantlymohoma). 3. Centroblastic lymphoma (centroblasticlymphoma) This disease is also known as malignant lymphoma with large non-cleaved follicular center cells. The disease is extremely rare, we have seen 2 cases. Accounted for 1.O% of skin NHL during the same period. There were 1 male and female, and the onset ages were 28 and 33 respectively. Skin damage is the same as CC. One case of facial tumor with local substantial swelling, normal hemoglobin anemia at the first diagnosis, advanced lymph nodes, liver and splenomegaly, patients died within 4 to 5 months after diagnosis. basic knowledge The proportion of illness: 0.0002% Susceptible people: good for middle and old people Mode of infection: non-infectious Complications: anemia
Cause
Secondary skin follicle center cell lymphoma
(1) Causes of the disease
The cause is not yet clear.
(two) pathogenesis
The pathogenesis is still unclear.
Prevention
Secondary skin follicle center cell lymphoma prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Secondary skin follicular central cell lymphoma complications Complications anemia
Currently there are no related content description.
Symptom
Secondary skin follicle central cell lymphoma symptoms common symptoms nodular scaly hair loss systemic failure splenomegaly
1. Centrocytic lymphoma (Shanghai) The dermatology department of Shanghai Huashan Hospital saw 7 cases, accounting for 3.1% of skin NHL in the same period. There were 6 males and 1 female. The median age of onset was 50.5 years old. ~5 months) Suddenly a single or multiple consistent skin nodules occur in a batch, hemispherical or oval, mostly higher than the leather surface, smooth surface, some with a small amount of scales, reddish, dark red, purple or Brown, 1 case of skin nodules as many as more than a thousand, advanced lymph nodes, liver, spleen often swollen, and finally irregular fever and systemic failure, in our 7 cases, except 1 case lost follow-up, 5 cases survived 12 ~ For 30 months, 1 patient died 14 months after diagnosis.
2. Center-blast-centrocytic lymphoma (centroblastic-centrocytic lymphoma) 9 cases of dermatology in Shanghai Huashan Hospital, accounting for 4.4% of skin NHL in the same period, 5 males and 4 females, with a median age of 37 years Skin damage is the same as CC. We have seen a case where the plaque is ring-shaped, the central part has hypopigmentation and hair loss, 2 cases have polymorphous erythema or rose prion-like rash in late stage, and 6 cases have normal hemoglobin anemia at the time of initial diagnosis. In the late stage of lymph node, liver and splenomegaly, in 9 cases, except 3 cases lost follow-up, 6 cases died within 4 to 6 months after diagnosis.
Examine
Secondary skin follicular central cell lymphoma examination
Histopathology:
1. Centrocytic lymphoma The nodular infiltration of the tumor cells mainly spreads in the deep or even subcutaneous tissue of the dermis, and is agglomerated along the blood vessels, around the appendage or at the small branches of the proximal nerve. Medium-sized, irregular and fissile than normal nuclei, fine chromatin, nucleoli are not obvious; cytoplasm is often rare and extremely weakly basophilic, tumor cells are negative for ANAE, ACP and POX; The B1 monoclonal antibody is positive, and in addition, some activated T cells, macrophages and dendritic reticulocytes are also seen.
2. Centroblastic-centrocytic lymphoma The tumor cells are diffusely infiltrated in the deep and even subcutaneous tissues of the dermis. The central blastoma cells are large or medium, with a vesicular nucleus and one or more. A distinct nucleolus, the nucleolus often attaches to the nuclear membrane of the short axis of the oval nucleus, and the cytoplasm is basophilic. Most of them are positive for MGP staining, immunolabeling shows B cell, and immunoglobulin F (ab) 2 fragment and C3 receptor, in addition to the majority of the above tumor cells, see also central cell tumor cells, the morphology is the same as seen in CC, in addition, some activated T cells, macrophages and trees are also seen. Megacytic cells.
3. Centroblastic lymphoma This disease is also known as malignant lymphoma with large non-cleaved follicular center cells. Histopathology indicates that the tumor cells are diffusely infiltrated. In the whole dermis and subcutaneous tissues, the morphology is the same as CB, and the immunolabeling indicates that the tumor cells are B-cell.
Diagnosis
Diagnosis and diagnosis of secondary skin follicular central cell lymphoma
Diagnostic criteria
Skin T cell lymphoma
Central cell lymphoma, especially due to poor biopsy or poor fixation, its nucleus often shrinks and deforms, and is difficult to distinguish from cutaneous T-cell lymphoma, but the latter has a focal positive reaction to ACP or ANAE, and is positive for L26 and B1. Negative reaction.
2. Chronic lymphocytic
Most of them are B-cell, which is often difficult to distinguish from central cell lymphoma, and can be identified in combination with clinical.
Differential diagnosis
1. Centroblastic-centrocytic lymphoma is associated with CC.
2. Centroblastic lymphoma
(1) Anaplastic large cell lymphoma: Although it can be B-cell, most tumor cells are positive for Ki-1.
(2) Immunoblastic lymphoma: It can be either T-cell or B-cell, and the latter has a large nucleolus.
