McClain Colt M, Cole Mary Beth, Robbins Jason B, Kantrow Sara M
Departments of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Cutan Pathol. 2012 Dec;39(12):1131-4. doi: 10.1111/cup.12009. Epub 2012 Sep 21.
We present the case of a 77-year-old male undergoing treatment for mycosis fungoides (MF) who presented for removal of an acrochordon on his mid back. Histopathologic examination of the acrochordon revealed a dense, band-like lymphocytic inflammatory infiltrate in the dermis with epidermotropism of single lymphocytes and small nests of lymphocytes into the lower epidermis. Immunohistochemical staining characterized the dermal and epidermal lymphocytic population as CD3-positive T lymphocytes with a predominance of CD4-positive over CD8-positive lymphocytes. These findings were consistent with the patient's known MF and molecular identification of a clonal T-cell receptor gene rearrangement further supported the diagnosis. Our unusual case reports MF involving an acrochordon and provides evidence to support the importance of submitting acrochordons for histopathologic examination.
我们报告一例77岁男性蕈样肉芽肿（MF）患者，该患者因背部中部的皮赘前来切除。皮赘的组织病理学检查显示真皮内有密集的带状淋巴细胞炎性浸润，单个淋巴细胞和小淋巴细胞巢向表皮下部亲表皮性浸润。免疫组织化学染色显示真皮和表皮淋巴细胞群为CD3阳性T淋巴细胞，CD4阳性淋巴细胞多于CD8阳性淋巴细胞。这些发现与患者已知的MF一致，克隆性T细胞受体基因重排的分子鉴定进一步支持了诊断。我们这一罕见病例报告了MF累及皮赘，并为支持将皮赘送检组织病理学检查的重要性提供了证据。
