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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。
One case of skin γ / δ T-cell lymphoma was reported. Female patient, 65 years old. Whole body nodules, plaque, ulcers with fever for 1 month. Rash first red nodules, rapidly increasing, increasing the formation of plaque and ulceration ulceration, conscious pain, with intermittent fever and swollen lymph nodes. Epidermal lesions showed no abnormalities in the dermis, immature lymphocytes in the dermis were pleomorphic, extensive sheet infiltration, especially in the appendages of the skin, perivascular and collagen bundles significantly infiltrated between the tumor cells were abnormally shaped. Skin lesions immunohistochemical examination: CD3, CD2, CD45RO positive, CD4, CD8, CD20, CD56, CD1O, CD30, T cell receptor receptor (TCR) TCRγ gene rearrangement analysis of T cell antigen receptor revealed that T cells were monoclonal and diagnosed as skin γ / δ T cell lymphoma. Patients with cyclophosphamide, pirarubicin, vindesine, prednisone, etoposide and other drug chemotherapy, the disease partially relieved, stop relapse after treatment, progress, and ultimately died after 8 months of onset.