报告1例原发性皮肤弥漫性大B细胞淋巴瘤,腿型。患者男,77岁。双小腿出现多个红褐色斑块和结节半年。皮损组织病理检查:肿瘤细胞无嗜表皮现象,表皮与真皮之间可见一条无细胞的透明带,真皮内可见较大的异形淋巴细胞样细胞浸润,肿瘤细胞体积大,大部分呈明显的圆形,细胞核大异形性明显,核分裂象易见。免疫组化:CD20(+)、CD79α(+)、B细胞淋巴瘤(B-cell lymphoma,Bcl)-2(+)、B细胞特异性激活蛋白(Pax)-5(+)、多发性骨髓瘤癌基因1(multiple myeloma oncogene 1,MUM1)(+)、肌酸激酶(CK)(-)、CD3(-)、Bcl-6(-)、CD10(-)、细胞周期素d1(Cyclin D-1)(-)、黑色素A(Melan A)(-)、CD7(-)、生长因子受体结合蛋白(Gr B)(-)、CD30(-)、CD56(-)、CD4(-)、CD8(-)及细胞核增殖抗原(Ki-67)约80%(+)。诊断:原发性皮肤弥漫性大B细胞性淋巴瘤,腿型。经过R-CHOP方案(环磷酰胺+表柔比星+长春新碱+泼尼松)化疗后,肿块明显退缩。 Report 1 cases of primary diffuse large B-cell lymphoma skin, leg type. Male patient, 77 years old. Multiple reddish brown patches and nodules appear for six months. Skin lesions histopathological examination: tumor cells without epidermis phenomenon, between the epidermis and dermis can be seen in a cell-free zona pellucida, the dermis can be seen larger abnormal lymphocyte-like cell infiltration, the tumor cells bulky, most of the obvious round Shape, obvious nuclear deformity, mitotic easy to see. Immunohistochemistry: CD20 (+), CD79α (+), B-cell lymphoma (Bcl) -2 (+), B cell specific activator protein (Pax) -5 Multiple myeloma oncogene 1 (MUM1), creatine kinase (CK), CD3 (-), Bcl-6, CD10 and Cyclin D (-), CD30 (-), CD56 (-), CD4 (-), Melan A (-), CD7 (-), growth factor receptor binding protein (Gr B) , CD8 (-) and cell proliferation antigen (Ki-67) about 80% (+). Diagnosis: Primary cutaneous diffuse large B-cell lymphoma, leg type. After R-CHOP regimen (cyclophosphamide + epirubicin + vincristine + prednisone) chemotherapy, the mass was significantly reduced.