Hauch T W, Shelbourne J D, Cohen H J, Mason D, Kremer W B
Ann Intern Med. 1975 Apr;82(4):499-505. doi: 10.7326/0003-4819-82-4-499.
A patient with mycosis fungoides developed meningeal disease while his skin disease was in remission with systemic chemotherapy. His central nervous system involvement with mycosis fungoides was controlled with intrathecal methotrexate for 7 months. The proliferating cells recovered from the spinal fluid showed similarities to the Sézary cell by light and electron microscopy. Surface receptor sutudies suggested that these cells were lymphoid cells of thymic derivation. Although mycosis fungoides has been shown to spread to the central nervous system in autopsied cases, reports of clinical neurologic disease are rare, and in only one earlier report have malignant cells have been found in the spinal fluid. Thus, as in other lymphoproliferative disorders, prompt consideration of meningeal involvement in a patient exhibiting neurologic symptoms while in peripheral remission may allow earlier treatment of this complication.
一名蕈样肉芽肿患者在其皮肤疾病经全身化疗缓解期间发生了脑膜疾病。他的蕈样肉芽肿累及中枢神经系统，通过鞘内注射甲氨蝶呤控制了7个月。从脑脊液中回收的增殖细胞在光学显微镜和电子显微镜下显示与Sezary细胞相似。表面受体研究表明这些细胞是胸腺来源的淋巴细胞。尽管在尸检病例中已证明蕈样肉芽肿可扩散至中枢神经系统，但临床神经疾病的报告很少，且仅有一份早期报告在脑脊液中发现了恶性细胞。因此，与其他淋巴增殖性疾病一样，对于在外周缓解期出现神经症状的患者，迅速考虑脑膜受累可能有助于更早地治疗这种并发症。
