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[儿童淋巴瘤样丘疹病:9例报告及文献复习]

[Lymphomatoid papulosis in children: report of 9 cases and review of the literature].

作者信息

Martorell-Calatayud A, Hernández-Martín A, Colmenero I, Vañó-Galván S, López-Obregón C, Armand A, Gambra Arzoz M, Torrelo A

机构信息

Hospital Infantil Niño Jesús, Madrid, España.

出版信息

Actas Dermosifiliogr. 2010 Oct;101(8):693-701.

Abstract

BACKGROUND

Lymphomatoid papulosis is a rare lymphoproliferative T cell CD30+ disease with excellent prognosis which affects almost exclusively adult patients, being rarely in the childhood; thus the clinic and pathologic spectrum and the risk of evolution to another type of lymphoma are not well defined in the pediatric group.

OBJECTIVE

The aim of this article is to analyze the characteristics of infantile lymphomatoid papulosis and review the literature.

MATERIAL AND METHOD

A retrospective study analyzing the characteristics of 9 patients aged up to 18 diagnosed of lymphomatoid papulosis attended in our department from 1995 to 2009 was performed.

RESULTS

The study included 7 boys and 2 girls aged between 2 and 17. Pityriasis lichenoides acuta's lesions appeared associated before and after lymphomatoid papulosis' development in 2 and 1 cases respectively. The lesions resolved spontaneously, leaving a postinflammatory hyperpigmentation (77%) or hypopigmentation (23%). The development of varioliform scars occurred in over 77% of cases. Histologically, all cases showed features compatible with type A of lymphomatoid papulosis. Molecular studies showed monoclonality in the 3 cases in which this technique was done.

CONCLUSIONS

Infantile lymphomatoid papulosis is a rare entity clinically manifested as the adult form. This lymphoproliferative disease, which is occasionally associated with pityriasis lichenoides acuta, shows features compatible with the type A or histiocytoid pattern in the histological analysis. The development of other lymphoproliferative disorders is less frequent in the infantile form than in the adulthood. The prevalent association among pityriasis lichenoides and lymphomatoid papulosis observed in our analysis, as well as the difficulties which supposed to differentiate between these two pathologies in various cases, suggest that those entities could be part of a common clinical and pathological spectrum.

摘要

背景

淋巴瘤样丘疹病是一种罕见的淋巴增生性T细胞CD30+疾病,预后良好,几乎仅累及成年患者,儿童罕见;因此,儿科患者的临床和病理谱以及演变为其他类型淋巴瘤的风险尚不明确。

目的

本文旨在分析婴儿淋巴瘤样丘疹病的特征并复习相关文献。

材料与方法

进行一项回顾性研究,分析1995年至2009年在我科就诊的9例年龄小于18岁的淋巴瘤样丘疹病患者的特征。

结果

该研究纳入了7名男孩和2名女孩,年龄在2至17岁之间。分别有2例和1例在淋巴瘤样丘疹病发生之前和之后出现急性苔藓样糠疹病变。病变均自发消退,遗留炎症后色素沉着(77%)或色素减退(23%)。超过77%的病例出现痘疮样瘢痕。组织学上,所有病例均表现出与淋巴瘤样丘疹病A型相符的特征。分子研究显示,在进行该技术检测的3例病例中呈单克隆性。

结论

婴儿淋巴瘤样丘疹病是一种罕见的疾病,临床表现与成人型相似。这种淋巴增生性疾病偶尔与急性苔藓样糠疹相关,组织学分析显示其特征与A型或组织细胞样模式相符。婴儿型淋巴瘤样丘疹病演变为其他淋巴增生性疾病的频率低于成人型。我们的分析中观察到的急性苔藓样糠疹与淋巴瘤样丘疹病之间的普遍关联,以及在各种病例中区分这两种疾病的困难,表明这些实体可能属于共同的临床和病理谱。

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