Yasui C, Fukaya T, Koizumi H, Kobayashi H, Ohkawara A
Department of Dermatology, Hokkaido University School of Medicine, Sapporo, Japan.
J Am Acad Dermatol. 1991 Apr;24(4):633-7. doi: 10.1016/0190-9622(91)70098-m.
Disseminated erythematous papules and plaques developed in a 60-year-old man 3 years before the appearance of neurologic manifestations. A biopsy specimen of the plaque revealed Pautrier's microabscess and a dense mononuclear cell infiltration with atypical convoluted nuclei in the papillary dermis. These cells were helper/inducer T lymphocytes that expressed the interleukin 2 receptor. The patient's white blood cell count was normal, but 1% atypical lymphocytes and a high titer of anti-human T-lymphotropic virus (HTLV)-I antibody were detected in his serum. A smoldering type of adult T-cell leukemia was diagnosed. While he was being treated with PUVA, a gait disturbance developed. A high titer of anti-HTLV-I antibody, characteristic of HTLV-I-associated myelopathy, was demonstrated in his cerebrospinal fluid.
一名60岁男性在出现神经学表现的3年前出现了播散性红斑丘疹和斑块。斑块的活检标本显示派特利微脓肿，乳头真皮层有密集的单核细胞浸润，细胞核呈非典型卷曲状。这些细胞是表达白细胞介素2受体的辅助/诱导性T淋巴细胞。患者白细胞计数正常，但血清中检测到1%的非典型淋巴细胞和高滴度的抗人类嗜T淋巴细胞病毒（HTLV）-I抗体。诊断为成人T细胞白血病的隐匿型。在接受补骨脂素紫外线A（PUVA）治疗期间，出现了步态障碍。其脑脊液中显示出高滴度的抗HTLV-I抗体，这是HTLV-I相关脊髓病的特征。
