Lok C, Viseux V, Denoeux J P, Bagot M
Service de Dermatologie, Centre Hospitalier Universitaire, Hôpital Sud, 80 054 Amiens Cedex 1, France.
Crit Rev Oncol Hematol. 2005 Oct;56(1):137-45. doi: 10.1016/j.critrevonc.2004.12.012.
Post-transplant cutaneous lymphomas are rare. Cutaneous T-cell lymphomas account for 30% of these lymphomas. The clinical appearance of the skin lesions is identical to cutaneous lymphomas observed in non-immunosuppressed patients, with infiltrated plaques, nodular and ulcerated tumors, but with an increased frequency of erythroderma. Standard histology and immunohistochemistry are also consistent with the features of mycosis fungoides and CD30+ cutaneous lymphomas observed in the general population. However, the pronostic differs from the usually favourable outcome of cutaneous T-cell lymphomas, as 8 out of the 13 patients of our series died, in less than 1 year for 6 of them. This unfavourable course appears to be the same as that observed for systemic T-cell lymphoma in transplant recipients. In contrast to post-transplant B-cell lymphomas (systemic and primary cutaneous), the link to a virus has not been demonstrated. The prognosis is also less favourable for post-transplant cutaneous T-cell lymphomas than for post-transplant cutaneous B-cell lymphomas.
移植后皮肤淋巴瘤较为罕见。皮肤T细胞淋巴瘤占这些淋巴瘤的30%。皮肤病变的临床表现与非免疫抑制患者中观察到的皮肤淋巴瘤相同,有浸润性斑块、结节状和溃疡性肿瘤,但红皮病的发生率增加。标准组织学和免疫组化也与普通人群中蕈样肉芽肿和CD30+皮肤淋巴瘤的特征一致。然而,预后与皮肤T细胞淋巴瘤通常良好的结果不同,我们系列中的13例患者中有8例死亡,其中6例在不到1年的时间内死亡。这种不利的病程似乎与移植受者中系统性T细胞淋巴瘤所观察到的情况相同。与移植后B细胞淋巴瘤(系统性和原发性皮肤型)不同,尚未证实其与病毒有关。移植后皮肤T细胞淋巴瘤的预后也比移植后皮肤B细胞淋巴瘤更差。