【摘要】 目的分析皮下脂膜炎样T细胞淋巴瘤的临床表现及病理组织学特征,探讨其诊断和治疗方法,提高临床医生对该病的认识。方法对1例面部和下肢浮肿及全身多发硬结1月余,发热1周的患者临床表现的演变、确诊时的组织病理学特点、免疫组织化学结果等多方面进行观察。结果皮肤活检发现组织学病变主要局限于皮下脂肪间质内见核深染的异型细胞弥漫分布或环绕脂肪细胞分布。免疫组化示CD3+,CD8+,CD68+,TiA-1+,G-B+,CD20-,CD7-,TDT-,提示为T细胞来源。治疗(环磷酰胺+长春新碱+表阿霉素)1疗程患者自动出院回家。结论皮下脂膜炎样T细胞淋巴瘤是一种特殊类型的原发性皮肤淋巴瘤,对不明原因的全身皮肤多发硬结伴发热的患者应该考虑该病的可能。病损处皮肤活检是确诊该病的主要手段。治疗常用联合化疗,如CHOP方案。本病预后较差。更多还原

【Abstract】 Objective To analyze the clinical manifestations and histopathological features of subcutaneous panniculitis-like T-cell lymphoma(SPTCL),and explore the methods for its diagnosis and treatment,and improve clinicians′ awareness of this disease.Method A reported case of SPTCL,a seventeen-year-old man suffering from a one-month history of swelling on his face and lower limbs,and multiple indurated plaques on his limbs and whole body,complicated by fever for more than a week was observed.The evolutive,histopathologic and immunophenotypic features of this patient were reviewed.Result The skin biopsy showed infiltration of hyperchromatic lymphocytes,either dispersed or concentrated around the fatty cells,in subcutaneous fatty tissue.Immunohistochemistry indicated positive labeling for CD3/CD8/CD68,G-B,and TIA-1,but negative for CD20/CD7 and TDT,suggesting a T-cell-originated lymphoma.The patient was treated with CHOP course.Conclusion SPTCL is a rare type of non-Hodgkin lymphoma infiltrating into subcutaneous tissue and it should be take into consideraton for the differential diagnosis of patients with systemic indurated plaques and fever.Despite its poor prognosis,a relatively aggressive chemotherapy can be performed.The final diagnosis is established mainly through the skin biopsy of the lesion,and the usual treatment counts on CHOP-like regimens.更多还原