论文部分内容阅读
目的报道1例皮肤型成人T细胞白血病/淋巴瘤(cATLL)。方法检测皮肤损害的组织病理、直接免疫荧光和免疫表型的特点,同时应用酶联免疫吸附试验、蛋白印迹法以及聚合酶链反应分别检测患者外周血中嗜人T淋巴细胞病毒Ⅰ型(HTLV-Ⅰ)抗体和淋巴样细胞的HTLV-Ⅰ前病毒DNA。结果此例患者的皮肤损害多形,除表现丘疹、斑块外,并发生疱壁紧张或松弛的大疱。组织病理检查示表皮下水疱,疱底真皮乳头和疱边缘处小至中等大不典型淋巴样细胞浸润。不典型淋巴样细胞示CD45+、CD45RO+,直接免疫荧光检查阴性。外周血中HTLV-Ⅰ抗体阳性;淋巴样细胞中HTLV-Ⅰ前病毒DNA阳性。患者最后死亡,病程1年10个月。结论ATLL在我国并非极罕见,cATLL也存在,应加以警惕。
Objective To report a case of cutaneous adult T cell leukemia / lymphoma (cATLL). Methods The histopathology, direct immunofluorescence and immunophenotyping of skin lesions were examined. The levels of human T-lymphotrophic virus type I (HTLV) in peripheral blood were detected by enzyme-linked immunosorbent assay, Western blotting and polymerase chain reaction -I) antibody and lymphoid cell HTLV-I proviral DNA. Results The skin lesions in this patient were pleomorphic, with the exception of the papules and plaques, and bullae with bulky or loose blisters. Histopathological examination revealed subepidermal blisters, vesicular dermal papillae and margins of small to medium large atypical lymphoid infiltrates. Atypical lymphoid cells showed CD45 +, CD45RO +, direct immunofluorescence negative. HTLV-Ⅰ antibody positive in peripheral blood; Lymphoid cells HTLV-Ⅰ proviral DNA positive. The patient died last one year and 10 months. Conclusion ATLL is not very rare in our country, cATLL also exists, should be vigilant.