背景:经典霍奇金淋巴瘤(CHL)的皮肤受累是当今时代极为罕见的现象。迄今为止,文献中从未报道过霍奇金淋巴瘤皮肤受累的单个大病例系列。
方法:在1990年至2020年之间,在不同机构中对指定为“皮肤”和“霍奇金”的病例进行了全面搜索。确定了25个病例,每例病例由至少3名经董事会认证的皮肤病理学家和/或血液病理学家独立审查.
结果:所有病例均为全身性CHL伴继发性皮肤播散的例子。单个病变,通常是肿瘤,56%的病例出现结节或浸润斑块,28%的病例出现多发病变.大多数患者(86%-12/14)在首次诊断时被诊断为IV期疾病。HL的临床(首次)诊断与皮肤病变发展之间的间隔为6至108个月(平均33.75个月)。对这些病例(在最初诊断时)的综合组织病理学评估显示,在60%的病例(15/25)中诊断为未另外指定的经典HL(NOS)。24%(6/25)的结节性硬化症类型,混合细胞率为12%(3/25),淋巴细胞耗竭4%(1/25)。
结论:我们提供了大量的CHL继发皮肤受累与CHL相关的文献,形态学,和免疫表型特征。
BACKGROUND: Cutaneous involvement by classic Hodgkin lymphoma (CHL) is an extraordinarily rare phenomenon in the current era. To date, no single large case series of cutaneous involvement by Hodgkin lymphoma has ever been reported in the literature.
METHODS: A comprehensive search for cases designated \"skin\" and \"Hodgkin\" was performed at different institutions between 1990 and 2020. Twenty-five cases were identified, and each case was independently reviewed by at least three board-certified dermatopathologists and/or hematopathologists.
RESULTS: All cases represented examples of systemic CHL with secondary skin dissemination. A single lesion, usually a tumor, nodule or infiltrative plaque was observed in 56% of cases and multiple lesions were present in 28% of cases. Most patients (86%-12/14) had a diagnosis of stage IV disease at first diagnosis. The interval between the clinical (first) diagnosis of HL and the development of skin lesions ranged between 6 and 108 months (average 33.75 months). Comprehensive histopathologic evaluation of these cases (at the initial diagnosis) revealed a diagnosis of classic HL not otherwise specified (NOS) in 60% of cases (15/25), nodular sclerosis type in 24% (6/25), mixed cellularity in 12% (3/25), and lymphocyte depleted in 4% (1/25).
CONCLUSIONS: We provide documentation of a large series of CHL with secondary skin involvement in association with CHL with additional clinical, morphologic, and immunophenotypic features.