误诊为麻风的伴有大细胞转化的肉芽肿性蕈样霉菌病。
Granulomatous mycosis fungoides with large cell transformation misdiagnosed as leprosy.
作者信息
Siriphukpong Sujittra, Pattanaprichakul Penvadee, Sitthinamsuwan Panitta, Karoopongse Ekapun
机构信息
Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
J Med Assoc Thai. 2010 Nov;93(11):1321-6.
BACKGROUND
Granulomatous mycosis fungoides is an unusual histopathological variant of cutaneous T-cell lymphoma without clinical distinction from classic mycosis fungoides. Symptoms associated with peripheral nerve involvement have rarely been reported in the literature.
CASE REPORT
The authors described a case of granulomatous MF stage IIB with large cell transformation who initially presented with leprosy-like condition and chronic left peroneal neuropathy The patient received six courses ofgemcitabine with greater than 90% improvement of skin lesions. The rest of the lesions were successfully treated with local electron beam radiation.
CONCLUSION
Granulomatous MF with neuropathy can be clinically misdiagnosed if there is no histopathological and immunohistochemical finding to support the diagnosis of lymphoma.
背景
肉芽肿性蕈样霉菌病是皮肤T细胞淋巴瘤一种不常见的组织病理学变异型，在临床上与经典蕈样霉菌病并无差异。文献中很少报道与周围神经受累相关的症状。
病例报告
作者描述了1例伴有大细胞转化的IIB期肉芽肿性蕈样霉菌病患者，该患者最初表现为麻风样病症和慢性左腓神经病变。患者接受了6个疗程的吉西他滨治疗，皮肤病变改善超过90%。其余病变通过局部电子束放射治疗成功治愈。
结论
如果没有组织病理学和免疫组化结果支持淋巴瘤的诊断，伴有神经病变的肉芽肿性蕈样霉菌病在临床上可能会被误诊。
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