腋窝皮肤弥漫性大B细胞淋巴瘤致巨大溃疡1例

A case with giant ulcer caused by skin diffuse large B-cell lymphoma in the axilla

Department of Burns, Tongren Hospital of Wuhan Univer-sity ＆ Wuhan Third Hospital, Wuhan 430060, China

摘要: 2019年5月16日，武汉大学同仁医院暨武汉市第三医院收治1例51岁、腋窝皮肤弥漫性大B细胞淋巴瘤致罕见巨大溃疡男性患者，对扩大切除的溃疡创面组织行活检和免疫组织化学分析，而后确诊。最终，采用皮瓣、皮片移植联合放射治疗以及化学治疗获得较好预后。
- 淋巴瘤，大B细胞，弥漫性 /
- 皮肤 /
- 放化疗，辅助 /
- 巨大溃疡 /
- 创面修复
Abstract: In May 16 ^th, 2019, a male patient (aged 51 years) with a rare giant ulcer caused by skin diffuse large B-cell lymphoma in the axilla was admitted to Tongren Hospital of Wuhan University ＆ Wuhan Third Hospital, and the ulcer wound was confirmed by biopsy and immunohistochemical analysis after extensive excision. Ultimately, a good prognosis was obtained by transplantation of flap and skin graft in combination with radiotherapy and chemotherapy.
- Lymphoma, large B-cell, diffuse /
- Skin /
- Chemoradiotherapy, adjuvant /
- Giant ulcer /
- Wound repair
所有作者均声明不存在利益冲突

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1 腋窝皮肤弥漫性大B细胞淋巴瘤致巨大溃疡患者入院后行皮瓣移植+皮片移植+化学治疗等的疗效。1A.患者腋窝发病1年余溃疡创面，面积大、基底情况差，可见坏死肌肉和窦道；1B、1C.分别为清创术后即刻及去除的病变组织，组织量大且分散；1D.图1C溃疡组织的病理情况，呈慢性化脓性炎症伴大量坏死，局部细胞增殖活跃，部分淋巴细胞围绕厚壁血管排列，小血管增生明显；1E.采用带蒂背阔肌肌皮瓣+游离股前外侧皮瓣封闭创面后即刻；1F.皮瓣移植术后1周创面，可见游离移植的股前外侧皮瓣坏死；1G.图1F中创面边缘组织的病理情况，与图1D类似；1H.植皮修复+化学治疗2个疗程后，创面接近痊愈；1I、1J.分别为随访3年时患者正前方和正后方情况，左侧（患侧）肩关节外展、上抬活动度与右侧（健侧）差异不明显

注：图1D和图1G为苏木精-伊红染色，放大倍数均为10倍

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