Medical academic journalMedical academic journalМедицинский академический журнал1608-41012687-1378Eco-Vector694088Clinical medicineКлиническая медицинаResearch ArticlePrimary and secondary skin damages in CD30+ lymphoproliferative disordersПервичные и вторичные поражения кожи при CD30+ лимфопролиферативных заболеванияхSamtsovA. V.СамцовА. В.
Russian Federation
medaj@eco-vector.comBelousovaI. E.БелоусоваИ. Э.
Russian Federation
medaj@eco-vector.comKazakovD. V.КазаковД. В.
Switzerland
medaj@eco-vector.comKempfV.КемпфВ.
Switzerland
medaj@eco-vector.comRussian Military Medical AcademyРоссийская военно-медицинская академияUniversity Hospital, ZurichУниверситетский госпиталь, Цюрих270220044162712310202523102025Copyright ©; 2004, Samtsov A.V., Belousova I.E., Kazakov D.V., Kempf V.Copyright ©; 2004, Самцов А.В., Белоусова И.Э., Казаков Д.В., Кемпф В.2004Samtsov A.V., Belousova I.E., Kazakov D.V., Kempf V.Самцов А.В., Белоусова И.Э., Казаков Д.В., Кемпф В.https://journals.eco-vector.com/MAJ/article/view/694088

Management of patients with CD30+ lymphoproliferative disorders varies from observations in case of relatively asymptomatic, spontaneously remitting disease (as in lymphomatoid papulosis) to multiagent chemotherapy regimens (as in disseminated CD30+ lymphoma), and the diagnosis requires the application of modern diagnostic tools. In our retrospective study two dermatopathologists independently reviewed 18 cases of CD30+ cutaneous lymphomas to determine the significance of each diagnostic methods. The study was carried out in four independent review sessions consisting of (1) review of histological sections only, (2) review of immunohistological sections, (3) introduction of the detailed clinical data and the history of disease, and (4) introduction of the outcome. Agreement with consensus was analyzed for every session and kappa statistics were calculated to evaluate the interobserver reliability. The results of our study show that the diagnosis of CD30+ cutaneous lymphomas has to be based on clinicopathologic correlation.

Тактика ведения больных с CD30+ лимфопролиферативными заболеваниями кожи варьирует от динамического наблюдения пациентов, имеющих относительно бессимптомную, спонтанно ремиттирующую болезнь (как при лимфоматоидном папулезе), до применения различных режимов полихимиотерапии (как при диссеминированной CD30+ анапластической лимфоме). Диагностика спектра этих заболеваний остается одной из самых сложных проблем в дерматологии и требует применения специализированных методов обследования. В проведенном нами ретроспективном межэкспертном исследовании 18 случаев CD30+ лимфом кожи были просмотрены и диагностированы независимо друг от друга двумя экспертами-дерматопатологами с целью оценки необходимости и информативности каждого из методов диагностики. Процесс постановки диагноза выполнялся в четыре этапа и включал в себя на первом этапе просмотр гистологического препарата, на втором - иммуногистохимической панели, на третьем - ознакомление с данными анамнеза, клинической картины и катамнеза, и на четвертом добавлялась катамнестическая информация. Уровень межэкспертного согласия диагнозов на всех четырех этапах с консенсусным диагнозом и достоверность результатов межэкспертной диагностики были оценены статистически. Результаты исследования показали, что окончательный диагноз CD30+ лимфопролиферативного заболевания кожи должен базироваться на корреляции клинических и патологических данных.

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