皮肤 B 细胞淋巴瘤

概述

皮肤 B 细胞淋巴瘤是一种罕见癌症，始发于白细胞。这种癌症会侵袭皮肤。皮肤 B 细胞淋巴瘤会影响一种称为 B 细胞的抗病菌白细胞。这些细胞又称为 B 淋巴细胞。

皮肤 B 细胞淋巴瘤的类型包括：

• 原发性皮肤滤泡中心淋巴瘤。
• 原发性皮肤边缘区 B 细胞淋巴瘤。
• 原发性皮肤弥漫性大 B 细胞淋巴瘤（腿部类型）。
• 血管内弥漫性大 B 细胞淋巴瘤。

皮肤 B 细胞淋巴瘤的症状包括皮肤上有一个肿块或一组肿块。有时这种癌症会导致皮肤出现硬斑块。

皮肤 B 细胞淋巴瘤是一种非霍奇金淋巴瘤。影响皮肤的另一种非霍奇金淋巴瘤被称为皮肤 T 细胞淋巴瘤。皮肤 T 细胞淋巴瘤比皮肤 B 细胞淋巴瘤更常见。

Types

The types of cutaneous B-cell lymphoma include:

• Primary cutaneous follicle center lymphoma. This is the most common type of cutaneous B-cell lymphoma. It appears mostly on the scalp, face, forehead and torso. Primary cutaneous follicle center lymphoma usually grows slowly and has an excellent prognosis.
• Primary cutaneous marginal zone B-cell lymphoma. This is the second most common type of cutaneous B-cell lymphoma. It appears mostly on the torso, arms and head. Primary cutaneous marginal zone B-cell lymphoma usually grows slowly and has an excellent prognosis. However, this type comes back in about half the people.
• Primary cutaneous diffuse large B-cell lymphoma, leg type. This is the rarest type of cutaneous B-cell lymphoma. It appears mostly on one or both legs but can be found elsewhere. Primary cutaneous diffuse large B-cell lymphoma, leg type usually grows fast and has a poor prognosis. This type has a high relapse rate and may spread beyond the skin when it comes back.
• Intravascular diffuse large B-cell lymphoma. This type is different from the other types of cutaneous B-cell lymphoma. It is not limited to the skin but forms in small blood vessels of the skin and elsewhere in the body. Because of this, it can affect any organ. The skin and central nervous system are the most common sites. When in the skin, it appears most often on the legs or torso. Some people may have a fever or have symptoms in the brain before having skin symptoms. Intravascular diffuse large B-cell lymphoma usually grows fast and has a poor prognosis.

症状

皮肤 B 细胞淋巴瘤通常表现为皮肤上不会消失的一个肿块或一组肿块。症状可能包括：

• 皮肤上有一个肿块或一组肿块。
• 皮肤上有看起来可能呈粉色、紫色或红棕色的肿块。
• 皮肤肿块周围发红。
• 皮肤肿块生长缓慢。

皮肤 B 细胞淋巴瘤通常生长在头皮、前额或背部。这种癌症的某些类型往往长在其他部位。原发性皮肤边缘区 B 细胞淋巴瘤大多出现在手臂或躯干上。原发性皮肤弥漫性大 B 细胞淋巴瘤（腿部类型）通常长在一条腿上。

血管内弥漫性大 B 细胞淋巴瘤引起的症状与其他类型不同。症状可能包括：

• 坚硬的皮肤斑块。
• 斑块周围的皮肤呈红色或紫色。
• 看似蛛网纹的皮肤部位。
• 躯干或大腿上的斑块。

Primary cutaneous follicle center lymphoma

Symptoms of primary cutaneous follicle center lymphoma may include firm, painless bumps or lesions. They may appear red, pink or another color depending on your skin color. These bumps or lesions most often happen on the head, especially the scalp, the neck and the upper torso. You may have one bump or lesion or a few grouped together. These often grow slowly.

Primary cutaneous marginal zone B-cell lymphoma

Symptoms of primary cutaneous marginal zone B-cell lymphoma may include bumps or lesions that are often soft. They may appear red, purple or another color depending on your skin color. This type happens most often on the torso or upper arms. It is common to have multiple bumps at once.

Primary cutaneous diffuse large B-cell lymphoma, leg type

Symptoms of primary cutaneous diffuse large B-cell lymphoma, leg type may include nodules or tumors on one or both lower legs. These bumps may appear red, blue or another color depending on your skin color. This type tends to grow quickly and can spread beyond the skin more easily than other types. Symptoms of spread may include swollen lymph nodes, drenching night sweats, fever, fatigue and losing weight without trying.

Intravascular diffuse large B-cell lymphoma

Symptoms of intravascular diffuse large B-cell lymphoma are often different from other types of cutaneous B-cell lymphoma. This type may appear as a bump or patchy area of skin or look similar to spider veins. The skin may be hard. It also may look purple or another color depending on your skin color. This type is often aggressive and can appear on the torso or thighs. It also can involve the brain or other organs and cause symptoms such as confusion, weakness, fever and fatigue.

何时就医

如果您有持续存在的令您担忧的症状，请与医生或其他医疗护理专业人员约诊。

病因

皮肤 B 细胞淋巴瘤的病因通常不明。这种癌症导致皮肤上出现细胞生长物。它始于称为淋巴细胞的抗菌白细胞。皮肤 B 细胞淋巴瘤会影响称为 B 淋巴细胞的特定淋巴细胞。

皮肤 B 细胞淋巴瘤发生是因为 B 淋巴细胞的 DNA 出现变化。细胞的 DNA 含有指示细胞进行哪些活动的指令。在正常细胞中，DNA 指令让细胞按设定速度生长和增殖。这些指令会指示细胞在设定的时间死亡。而在癌细胞中，DNA 的变化给出了不同的指令。这些变化指示癌细胞迅速生长和增殖。在正常细胞应该死亡时，癌细胞仍继续存活。这会导致细胞过多。

患皮肤 B 细胞淋巴瘤时，癌细胞会在皮肤中积聚。在极少数情况下，癌细胞会扩散到身体其他部位。

风险因素

皮肤 B 细胞淋巴瘤的风险因素包括：

• 免疫系统功能低下。 如果药物或疾病导致机体抵御病菌的免疫系统功能减弱，患皮肤 B 细胞淋巴瘤的风险可能更高。免疫系统功能低下的人群可能包括使用药物控制免疫系统的人群，如器官移植后的人群。某些健康状况（包括 HIV 感染）也可能会削弱免疫系统。
• 通过蜱传播的细菌。 有些蜱能传播称为疏螺旋体的细菌。疏螺旋体细菌与莱姆病相关。一些研究还将疏螺旋体细菌与皮肤 B 细胞淋巴瘤联系起来。

目前尚无预防皮肤 B 细胞淋巴瘤的方法。

并发症

Cutaneous B-cell lymphoma may cause complications such as:

• Relapse. Even after successful treatment, cutaneous B-cell lymphoma may come back. This is called a relapse. The risk of relapse is highest in people with primary cutaneous diffuse large B-cell lymphoma, leg type.
• Spread beyond the skin. Primary cutaneous diffuse large B-cell lymphoma, leg type may spread to areas beyond the skin. It may spread to the lymph nodes, bone marrow, or organs such as the liver or lungs. Cancer that spreads beyond the skin is called systemic lymphoma.

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