Granel B, Serratrice J, Swiader L, Horshowski N, Blaise D, Vey N, Metras D, Habib G, Disdier P, Weiller P J
Service de Médecine Interne, Hôpital de la Timone, Marseille Cedex, France.
Cancer. 2000 Nov 15;89(10):2138-43. doi: 10.1002/1097-0142(20001115)89:10<2138::aid-cncr15>3.0.co;2-w.
Previous reports have found an association between lymphomatoid papulosis and hypereosinophilic syndrome, as well as lymphomatoid papulosis and lymphoma. In the current study the authors report what to their knowledge is the first reported case of these three diseases occurring simultaneously in the same patient.
The authors followed the clinical course of a 64-year-old man with lymphomatoid papulosis associated with severe hypereosinophilic syndrome complicated by involvement of the lungs and heart.
After 6 years of follow-up, the patient developped a large T-cell, CD30 positive lymphoma. The bone marrow biopsy was typical of hypereosinophilic syndrome associated with fibrosis, with focal lymphomatous infiltrates comprised of large cells resembling the type A cells of lymphomatoid papulosis. Complete remission of the lymphoma was obtained with chemotherapy.
This exceptional case report suggests a link between the three diseases. Lymphomatoid papulosis belongs to the spectrum of CD30 positive lymphoproliferative disorders and CD30 positive lymphocytes of lymphomatoid papulosis are known to have a Th2 profile with possible secretion of eosinopoietic cytokines.
既往报告发现淋巴瘤样丘疹病与嗜酸性粒细胞增多综合征之间存在关联，以及淋巴瘤样丘疹病与淋巴瘤之间存在关联。在本研究中，作者报告了据他们所知首例这三种疾病同时发生在同一患者身上的病例。
作者追踪了一名64岁患有淋巴瘤样丘疹病且伴有严重嗜酸性粒细胞增多综合征并累及肺和心脏的男性患者的临床病程。
经过6年的随访，该患者发展为大T细胞、CD30阳性淋巴瘤。骨髓活检是典型的伴有纤维化的嗜酸性粒细胞增多综合征，伴有由类似于淋巴瘤样丘疹病A型细胞的大细胞组成的局灶性淋巴瘤浸润。化疗使淋巴瘤完全缓解。
这一特殊病例报告提示了这三种疾病之间的联系。淋巴瘤样丘疹病属于CD30阳性淋巴增殖性疾病谱，已知淋巴瘤样丘疹病的CD30阳性淋巴细胞具有Th2表型，可能分泌嗜酸性粒细胞生成细胞因子。
