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首页> 外文期刊>Journal of cutaneous pathology >Incidental chronic lymphocytic leukaemia in a biopsy of Merkel cell carcinoma.
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Incidental chronic lymphocytic leukaemia in a biopsy of Merkel cell carcinoma.

机译：默克细胞癌活检中偶然的慢性淋巴细胞性白血病。

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摘要

Chronic lymphocytic leukaemia (CLL) shows cutaneous involvement in 2% of cases. Merkel cell carcinoma (MCC) is a rare primary cutaneous epithelial neoplasm most commonly found in sun-exposed sites in elderly male Caucasians. A 66-year-old man presented with a 2-month history of a purple painless 2 cm tumor on the scalp. Excision biopsy revealed an incompletely excised MCC, and at the periphery of the MCC, a lymphocytic infiltrate interpreted as reactive. A re-excision biopsy showed residual MCC as well as dense aggregates of small lymphocytes within and surrounding the MCC. Immunohistochemistry showed characteristic dot-like cytoplasmic positivity for cytokeratin 20 in the MCC; the lymphocytic infiltrate was positive for CD5, CD20 and CD23, diagnostic of CLL. Subsequent staging revealed widespread lymphadenopathy, and lymph node biopsy showed CLL. Histologically, CLL and MCC are 'round blue cell tumors' and are therefore in the differential diagnoses of each other. Whenever there is a more prominent than expected infiltrate of small lymphocytes surrounding a skin lesion in an elderly patient, immunohistochemistry to rule out CLL is advised. This case adds to the literature suggesting an increased incidence of CLL and other neoplasms in patients with MCC and vice versa.
机译：慢性淋巴细胞性白血病（CLL）在2％的病例中显示皮肤受累。默克尔细胞癌（MCC）是一种罕见的原发性皮肤上皮性肿瘤，最常见于年长男性高加索人暴露于阳光的部位。一名66岁的男子在头皮上出现2个月的紫色无痛2 cm肿瘤病史。切除活检显示MCC切除不完全，在MCC的周围，淋巴细胞浸润被解释为反应性的。再次行活检显示残留的MCC以及MCC内和周围的小淋巴细胞的密集聚集。免疫组化显示MCC中细胞角蛋白20的特征性点状细胞质阳性。 CD5，CD20和CD23淋巴细胞浸润呈阳性，可诊断CLL。随后的分期显示广泛的淋巴结肿大，淋巴结活检显示为CLL。从组织学上讲，CLL和MCC是“圆形蓝细胞肿瘤”，因此在彼此的鉴别诊断中。每当老年患者皮肤病变周围的小淋巴细胞浸润比预期的突出时，建议采用免疫组化方法排除CLL。该病例增加了文献，提示MCC患者中CLL和其他肿瘤的发生率增加，反之亦然。

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