Lemordant P, Boye T, Fournier B, Guennoc B, Kaplanski G, Menard G, Carsuzaa F
Service de Dermatologie, HIA Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon.
Ann Dermatol Venereol. 2006 Oct;133(10):788-90. doi: 10.1016/s0151-9638(06)71045-6.
Splenic lymphoma with villous lymphocytes is occasionally associated with chronic hepatitis C infection. Antiviral hepatitis C therapy has been recently reported to be efficacious against splenic lymphoma with villous lymphocytes. We report a new case revealed by cutaneous symptoms.
A 53-year-old patient with arthritis and neuropathy of the lower limbs consulted for vascular purpura on both legs. The blood picture showed an increase in villous lymphocytes leading to a diagnosis of splenic lymphoma with villous lymphocytes. Histologic examination of a cutaneous biopsy specimen showed thrombosis of the superficial dermal vessels, associated with cryoglobulinemia with renal and neurologic failure, a satellite of hepatitis C virus infection. The patient was treated with interferon, ribavirin and plasmapheresis.
Vascular purpura, often associated with cryoglobulinemia, may reveal chronic hepatitis C infection. The efficacy of interferon and ribavirin treatment for splenic lymphoma with villous lymphocytes associated with hepatitis C infection has already been documented, and results in remission of cryoglobulinemia and lymphoma as well a eradication of viral load in 78% patients.
伴有绒毛状淋巴细胞的脾淋巴瘤偶尔与丙型肝炎病毒慢性感染相关。最近有报道称，抗病毒丙肝治疗对伴有绒毛状淋巴细胞的脾淋巴瘤有效。我们报告一例因皮肤症状而被发现的新病例。
一名53岁的患者，患有关节炎和下肢神经病变，因双腿出现血管性紫癜前来就诊。血常规显示绒毛状淋巴细胞增多，从而诊断为伴有绒毛状淋巴细胞的脾淋巴瘤。皮肤活检标本的组织学检查显示，浅表真皮血管血栓形成，伴有冷球蛋白血症及肾衰竭和神经功能衰竭，这是丙型肝炎病毒感染的一个相关表现。该患者接受了干扰素、利巴韦林和血浆置换治疗。
血管性紫癜常与冷球蛋白血症相关，可能提示丙型肝炎病毒慢性感染。干扰素和利巴韦林治疗对与丙型肝炎感染相关的伴有绒毛状淋巴细胞的脾淋巴瘤的疗效已有文献记载，可使冷球蛋白血症和淋巴瘤缓解，并使78%的患者病毒载量消除。
