毛細血管拡張症から診断したangiotropic B cell lymphomaの1例

Angiotropic lymphoma is a rare lymphoproliferative disease that affects vessels of all organs especially including the skin and central nervous system. We report a 67-year-old woman with angiotropic B cell lymphoma. Examination revealed striking telangiectasia on the skin of the chest and upper back as the major manifestation. She also had subacute slight disorientation.Laboratory abnormalities showed elevated serum lactic dehydrogenase (LDH) (2027U/l) . A skin biopsy from the telangiectasia revealed the presence of many intravascular, large, atypical lymphoid cells with hyperchromatic nuclei.On immunohistochemical analysis, neoplastic cells showed reactivity for CD20 but not CD45RO. These findings were consistent with angiotropic B cell lymphoma. By combination chemotherapy (VAB-COP: cyclophosphamide, adriamycin, etoposide, vincristin, bleomycin and prednisolone), the telangiectasia and disorientation were dramatically improved during the follow-up period. An early diagnosis and subsequent combinatio chemotherapy may contribute to longer survival in angiotropic lymphoma. [Skin Cancer (Japan) 2002; 17: 293-295]