原发性皮肤CD30+间变性大细胞淋巴瘤1例

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患者女,63岁。因左足背肿块伴溃疡8个月,加重1个月,于2010年6月22日入院。患者8个月前左足背出现约鹌鹑蛋大肿块,随后出现溃疡,未予诊治。此后肿块及溃疡面逐渐增大,伴明显疼痛。1个月前肿块表面少量血性及脓性分泌物,伴持续性疼痛,至当地医院就诊,组织病理检查示:大片坏死物,考虑慢性炎症伴纤维蛋白渗出,非典型分枝杆菌感染可能,予哌拉西林舒巴坦钠2.5 g静脉滴注,每日2次、左氧氟沙星0.5 g口服,每日1次抗感染,利福平0.3 g口服,每日1次、乙胺丁醇0.75 g口服,每日1次、复方磺胺甲恶唑1 g口服,每日1次,抗分枝杆菌治疗20 d,疗效不佳。既往右足背肿块切除术后4年,术后组织病理提示非霍奇金淋巴瘤。 Female patient, 63 years old. Due to left foot and back with ulcer 8 months, an increase of 1 month, on June 22, 2010 admission. 8 months ago, patients appeared about the left foot and quail egg big mass, followed by ulcers, not treated. Since then the mass and ulcers gradually increased, with obvious pain. A small amount of bloody and purulent discharge on the surface of the mass 1 month ago with persistent pain went to the local hospital for treatment. Histopathological examination revealed large necrosis, chronic inflammation with fibrin exudation, possible atypical Mycobacterium infection, Piperacillin and sulbactam sodium 2.5 g intravenously, twice daily, levofloxacin 0.5 g orally, once daily anti-infective, rifampicin 0.3 g orally, once daily, ethambutol 0.75 g orally , Once a day, the compound sulfamethoxazole 1 g orally, once daily, anti-mycobacterium 20 d, poor efficacy. In the past four years after resection of the right foot mass, histopathology suggested non-Hodgkin’s lymphoma.
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