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A Case of an Unusually Aggressive Cutaneous Anaplastic Large T-Cell Lymphoma in an HIV Patient Treated with CHOP

机译:用CHOP治疗的HIV病人异常侵袭性皮肤间变性大T细胞淋巴瘤一例

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摘要

Anaplastic large cell lymphoma (ALCL) is the second most common malignancy of T-cell phenotype. This case report describes an unusual rapidly progressing cutaneous anaplastic large T-cell lymphoma in an HIV patient. Our patient is a twenty-year-old African American male with perinatally acquired HIV who presented with a 2 × 2 centimeter necrotic lesion in the right 1st toe; however, 2-3 weeks later multiple smaller lesions appeared on the anterior aspect of the right foot, ankle, and thigh. Biopsy showed cells strongly positive for CD3 and CD30 and negative for CD56 and the ALK gene product. CT of the chest, abdomen, and pelvis was negative for extracutaneous involvement favoring cutaneous ALCL. Patient was treated with 6 cycles of CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) chemotherapy and went into complete remission. Due to the aggressive course that this malignancy follows in HIV patients we suggest prompt treatment with systemic therapy.
机译:间变性大细胞淋巴瘤(ALCL)是T细胞表型的第二大最常见恶性肿瘤。该病例报告描述了HIV患者中异常快速发展的皮肤间变性大T细胞淋巴瘤。我们的患者是一名20岁的非洲裔美国人男性,患有围产期感染的HIV,在右1趾出现2×2厘米的坏死病灶。但是,2-3周后,右脚,脚踝和大腿的前部出现了多个较小的病变。活检显示细胞对CD3和CD30呈强阳性,而对CD56和ALK基因产物呈阴性。胸部,腹部和骨盆的CT表现为皮外受累阴性,有利于皮肤ALCL。患者接受了6个周期的CHOP(环磷酰胺,羟基柔红霉素,长春新碱和泼尼松)化疗,均已完全缓解。由于在HIV患者中恶性程度高,因此建议立即进行全身治疗。

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