麻风复发误诊为假性淋巴瘤  

Leprosy relapse misdiagnosed as cutaneous pseudolymphoma

作　　者：石秀艳 周文生 王飞[2] 

机构地区：[1]南京市职业病防治院皮肤科,江苏南京210042 [2]东南大学附属中大医院皮肤科,江苏南京210009

出　　处：《临床皮肤科杂志》2018年第1期52-55,共4页Journal of Clinical Dermatology

摘　　要：报告1例麻风复发误诊为假性淋巴瘤。患者男,72岁。面部浸润性红斑伴瘙痒7个月。患者50余年前被诊断为瘤型麻风(LL),经氨苯砜(DDS)治疗临床判愈。1年前左眼睑水肿性红斑,在外院以"假性淋巴瘤"行皮损切除。皮肤科检查:额部浸润性红斑,约手掌大,境界不清,左眶上神经增粗。皮损组织液涂片抗酸杆菌(++^+++++)。皮损组织病理检查:表皮萎缩,表皮下可见无浸润带;真皮全层弥漫性以组织细胞为主的少量淋巴细胞浸润,部分浸润细胞呈泡沫样;抗酸染色可见大量抗酸染色阳性杆菌。诊断:(1)麻风复发;(2)界线类偏瘤型麻风伴Ⅰ型麻风反应。A case of leprosy relapse misdiagnosed as cutaneous pseudolymphoma is reported. A 72-year-old man presented with red plaques on his forehead for 7 months. Fifty years ago, he was diagnosed as lepromatous leprosy, which was clinically cured with DDS. One year ago, he was diagnosed as cutaneous pseudolymphoma because of an edematous erythema on the left upper eyelid. The lesion was surgically removed in other hospital. Physical examination showed palm-sized infiltrative erythematous plaques on the forehead, with unclear boundaries. The left nervus supraorbitalis was thicker than normal. Multiple acid-fast bacilli （AFB） could be seen in tissue fluid smear. Histopathological examination demonstrated epidermal atrophy and band of Unna. There were diffuse infiltration of histiocytes and lymphocytes in the dermis. Some infiltrated cells appeared foamy-like. Acid-fast staining showed abundant acid-fast bacilli. The diagnosis was leprosy relapse and borderline leprosy（BL） with type I reaction. infiltration

关 键 词：麻风 界线类偏瘤型 复发 误诊 皮肤假性淋巴瘤 皮肤淋巴细胞浸润症 

分 类 号：R754.9[医药卫生—皮肤病学与性病学]