Ravat Farhana E, Spittle Margaret F, Russell-Jones Robin
Department of Dermatology, Addenbrooke's NHS Trust, Cambridge, United Kingdom.
J Am Acad Dermatol. 2006 Apr;54(4):668-75. doi: 10.1016/j.jaad.2005.10.015.
Lymphoma occurring after organ transplantation has been well described. The majority of cases are B-cell lymphomas and are usually associated with Epstein-Barr virus. Only a minority of posttransplant lymphomas are of T-cell origin, and primary cutaneous T-cell lymphoma (CTCL) is extremely rare. In this article, we report a case of cutaneous peripheral T-cell lymphoma, pleomorphic CD30+ large-cell type, and review the literature relating to posttransplant primary CTCL. Of the 23 cases of posttransplant primary CTCL, 5 patients had erythrodermic disease, and 8 had primary cutaneous anaplastic large cell lymphoma. In addition, there are two cases of mycosis fungoides, one case of subcutaneous panniculitis-like T-cell lymphoma, one case of CD30+ lymphomatoid papulosis, and 6 cases of peripheral T-cell lymphoma, of which 3 were CD30+ large cell lymphomas. Seventeen cases had renal transplants and the majority received both cyclosporine and azathioprine. No consistent viral association was noted among these cases. The sex ratio was 18:5 (male/female), and the mean age at diagnosis was 53 years. Mean time from transplantation to diagnosis is 6.4 years and mean survival time from diagnosis is 14.5 months. The prognoses normally associated with particular subsets of CTCL do not apply in the posttransplant setting.
器官移植后发生的淋巴瘤已有详尽描述。大多数病例为B细胞淋巴瘤，通常与EB病毒有关。移植后淋巴瘤只有少数起源于T细胞，原发性皮肤T细胞淋巴瘤（CTCL）极为罕见。在本文中，我们报告了1例皮肤外周T细胞淋巴瘤、多形性CD30 +大细胞型病例，并复习了与移植后原发性CTCL相关的文献。在23例移植后原发性CTCL病例中，5例患有红皮病，8例患有原发性皮肤间变性大细胞淋巴瘤。此外，有2例蕈样肉芽肿、1例皮下脂膜炎样T细胞淋巴瘤、1例CD30 +淋巴瘤样丘疹病以及6例外周T细胞淋巴瘤，其中3例为CD30 +大细胞淋巴瘤。17例进行了肾移植，大多数患者同时接受了环孢素和硫唑嘌呤治疗。在这些病例中未发现一致的病毒关联。男女比例为18:5（男/女），诊断时的平均年龄为53岁。从移植到诊断的平均时间为6.4年，从诊断开始的平均生存时间为14.5个月。通常与CTCL特定亚群相关的预后情况在移植后环境中并不适用。
