Department of Infectious Diseases, University Medical Center Ljubljana.
Medical Faculty, Institute of Microbiology and Immunology.
Clin Infect Dis. 2016 Oct 1;63(7):914-21. doi: 10.1093/cid/ciw417. Epub 2016 Jun 21.
Information on the course and outcome of borrelial lymphocytoma (BL) is limited.
The study comprised 144 adult patients (75 female, 69 male; median age, 49 years) who had BL diagnosed at a single center between 1986 and 2014 and were followed up for 1 year.
BL was located on the breast in 106 patients (73.6%), on the ear lobe in 27 (18.8%), and elsewhere in 11 (7.6%). The median duration of BL before diagnosis was 27 days (interquartile range [IQR], 9-68 days). Concomitant erythema migrans was registered in 104 of 144 patients (72.2%); other objective manifestations of Lyme borreliosis (LB) were present in 11 (7.6%). Immunoglobulin M and/or G borrelial serum antibodies were present in 72 patients (50%). Borreliae were isolated from BL lesions in 14 of 42 patients (33.3%) who had not received antibiotics before skin biopsy. Of 13 typed Borrelia strains, 11 were B. afzelii, 1 was B. garinii, and 1 was B. bissettii The median duration of BL after starting antibiotic treatment was 21 days ([IQR], 10-30 days); the average duration was longer in patients who were older, had longer BL duration before treatment, or had signs of disseminated LB. Treatment failure occurred in 14 of 144 patients (9.7%). Patients with signs or symptoms of disseminated LB before treatment had nearly 4 times higher odds of treatment failure (95% confidence interval, 1.22-13.07) than those without such symptoms. All patients with treatment failure had uneventful outcome after retreatment.
BL is a rare manifestation of early localized LB. Fourteen-day antibiotic treatment, as used for erythema migrans, is effective.
关于伯氏疏螺旋体淋巴细胞瘤（BL）的病程和转归的信息有限。
本研究纳入了 1986 年至 2014 年间在单一中心确诊为 BL 的 144 例成年患者（75 例女性，69 例男性；中位年龄 49 岁），并对其进行了为期 1 年的随访。
BL 位于乳房的 106 例（73.6%），耳垂的 27 例（18.8%），其他部位的 11 例（7.6%）。BL 在诊断前的中位时间为 27 天（四分位距 [IQR]，9-68 天）。144 例患者中有 104 例（72.2%）伴有游走性红斑；其他客观的莱姆疏螺旋体病（LB）表现为 11 例（7.6%）。72 例（50%）患者存在免疫球蛋白 M 和/或 G 伯氏疏螺旋体血清抗体。在未经抗生素治疗而行皮肤活检的 42 例患者中，有 14 例（33.3%）从 BL 病变中分离出伯氏疏螺旋体。在 13 株分型的伯氏疏螺旋体菌株中，11 株为阿氏疏螺旋体，1 株为伽氏疏螺旋体，1 株为比斯氏疏螺旋体。开始抗生素治疗后 BL 的中位时间为 21 天（IQR，10-30 天）；在年龄较大、治疗前 BL 持续时间较长或有播散性 LB 表现的患者中，平均持续时间较长。144 例患者中有 14 例（9.7%）治疗失败。治疗前有 LB 播散症状或体征的患者治疗失败的可能性几乎是无此类症状患者的 4 倍（95%置信区间，1.22-13.07）。所有治疗失败的患者在再次治疗后均无不良后果。
BL 是早期局限性 LB 的罕见表现。14 天抗生素治疗，如用于游走性红斑，是有效的。
