皮肤γ/δ T细胞淋巴瘤  

Gamma/delta T-cell lymphoma of the skin:a case report

作　　者：韩静倩[1] 纪华安[1] 肖尹[1] 

机构地区：[1]天津市长征医院皮肤科,天津300120

出　　处：《临床皮肤科杂志》2014年第5期295-297,共3页Journal of Clinical Dermatology

摘　　要：报告1例皮肤γ/δT细胞淋巴瘤。患者女,65岁。全身出现结节、斑块、溃疡伴发热1个月。皮疹初起为红色结节,迅速增多、增大形成斑块,并破溃形成溃疡,自觉疼痛,伴间歇性发热和淋巴结肿大。皮损组织病理示表皮未见异常,真皮层内幼稚淋巴细胞呈多形性,广泛片状浸润,尤以皮肤附属器官、血管周围和胶原束之间浸润显著,肿瘤细胞明显异形。皮损免疫组化检查:CD3、CD2、CD45RO阳性,CD4、CD8、CD20、CD56、CD1O、CD30、T细胞抗原受体(TCR)βF1均为阴性。T细胞抗原受体TCRγ基因重排分析显示T细胞呈单克隆性增生,诊断为皮肤γ/δT细胞淋巴瘤。患者以环磷酰胺、吡柔比星、长春地辛、泼尼松、依托泊苷等药物化疗,病情部分缓解,停止治疗后仍复发、进展,最终于发病8个月后死亡。A case of gamma/delta T-cell lymphoma of the skin is reported. A 65-year-old woman presented with a recurrent fever and nodules, plaques and ulcers over the whole body for 1 month. The lesions began with red nodules, and then rapidly developed into painful plaques and ulcers. The patient had an intermittent fever and multiple swollen lymph nodes. Histologi- cal examination showed infiltration of atypical pleomorphic T cells throughout the dermis,especially around the adnexa, vessels and collagen. The epidermis was normal. Immunohistochemical staining showed positive for CD2, CD3 and CD45RO, and nega- tive for CD4, CD8, CD20, CD56, CD10, CD30 and TCRI3F1. Analysis of TCR-~ receptor rearrangement gene showed mono- clonal T-cell proliferation. The patient was diagnosed as cutaneous Gamma/delta T-cell lymphoma. Treatment with the combi- nation of cyclophosphamide, pirarubicin, vindesine, prednisone and etoposide resulted in partial remission of the skin lesions. Recurrence occurred after the patient ceased the treatment and she eventually died 8 months after the onset of disease.

关 键 词：γ δT细胞 淋巴瘤 皮肤 

分 类 号：R739.5[医药卫生—肿瘤]