Kadin M E
Department of Pathology, Beth Israel Hospital, Boston, MA 02115.
Semin Dermatol. 1991 Sep;10(3):164-71.
Lymphomatoid papulosis (LyP), Ki-1 lymphoma, and primary cutaneous, Hodgkin's disease (HD) appear to be histogenetically related disorders derived from activated T cells that express HD-associated antigens. Despite their morphologic and immunologic similarities, each disorder has a different clinical presentation and prognosis. LyP is associated with a long benign course of regressing papular lesions. The risk of developing a malignant lymphoma is approximately 10% to 20%. Ki-1 lymphoma, formerly known as regressing atypical histiocytosis (RAH), usually presents as one to several large lesions that can metastasize to regional lymph nodes. Single lesions can be treated by excision and local radiotherapy. Chemotherapy is necessary to control extracutaneous disease. Primary cutaneous HD probably does exist as a rare, often deep seated, nodular disorder that usually has a good prognosis. It should be distinguished from stage IV HD, which carries a grave prognosis. Evidence of associated nodal HD should be investigated in patients who present with skin lesions morphologically and immunologically indistinguishable from HD.
淋巴瘤样丘疹病(LyP)、Ki-1淋巴瘤和原发性皮肤霍奇金病(HD)似乎是起源于表达HD相关抗原的活化T细胞的组织发生学相关疾病。尽管它们在形态学和免疫学上有相似之处,但每种疾病都有不同的临床表现和预后。LyP与丘疹性病变消退的长期良性病程相关。发展为恶性淋巴瘤的风险约为10%至20%。Ki-1淋巴瘤,以前称为消退性非典型组织细胞增生症(RAH),通常表现为一到几个可转移至区域淋巴结的大病变。单个病变可通过切除和局部放疗进行治疗。控制皮肤外疾病需要化疗。原发性皮肤HD可能确实作为一种罕见的、通常深部的结节性疾病存在,其预后通常良好。它应与预后严重的IV期HD相鉴别。对于出现形态学和免疫学上与HD无法区分的皮肤病变的患者,应调查是否存在相关的淋巴结HD证据。