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皮下脂膜炎样T细胞淋巴瘤的临床特征、鉴别诊断及治疗结果:对已发表日本病例的文献综述

Clinical characteristics, differential diagnosis, and treatment outcome of subcutaneous panniculitis-like T-cell lymphoma: a literature review of published Japanese cases.

作者信息

Ohtsuka Mikio, Miura Takako, Yamamoto Toshiyuki

机构信息

Department of Dermatology, Fukushima Medical University School of Medicine, Fukushima, Japan.

出版信息

Eur J Dermatol. 2017 Feb 1;27(1):34-41. doi: 10.1684/ejd.2016.2914.

DOI:10.1684/ejd.2016.2914
PMID:28120776
Abstract

BACKGROUND

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of non-Hodgkin lymphoma that shows phenotypic features of cytotoxic T cells and preferentially involves subcutaneous tissue. SPTCL is believed to show an indolent clinical course, unless patients develop haemophagocytic syndrome. Various reported therapies include corticosteroids, immunosuppressive drugs, and chemotherapies. The use of chemotherapy as a first-line treatment remains controversial, and treatment approaches for SPTCL have not been established yet.

OBJECTIVES

To investigate the clinicopathological features, treatment modalities, and outcomes of Japanese patients with SPTCL.

MATERIALS & METHODS: We performed a literature review of Japanese cases of SPTCL.

RESULTS

Twenty-two cases have been reported in the English and Japanese literature. Six cases were excluded due to a lack of sufficient clinical and immunohistological data, and treatment modalities and outcome were available in 16 cases. Clinical characteristics of the Japanese cases were generally similar to those of Western countries. Approximately half of the Japanese patients were treated initially with corticosteroids. Among them, more than half subsequently received chemotherapies due to a lack of response or recurrence of the disease. Overall, chemotherapy was used for approximately 80% of reported cases as a primary or secondary therapy.

CONCLUSION

Our findings suggest that corticosteroids may be beneficial for some SPTCL patients, but most patients required chemotherapy during the course of their disease. Further investigations are needed to both establish appropriate treatment strategies for SPTCL and clarify predictive factors in order to identify patients who may benefit from corticosteroid therapy as a primary treatment.

摘要

背景

皮下脂膜炎样T细胞淋巴瘤(SPTCL)是非霍奇金淋巴瘤的一种罕见亚型,具有细胞毒性T细胞的表型特征,且优先累及皮下组织。除非患者并发噬血细胞综合征,SPTCL一般被认为临床病程呈惰性。各种报道的治疗方法包括皮质类固醇、免疫抑制药物和化疗。将化疗作为一线治疗的应用仍存在争议,且SPTCL的治疗方法尚未确立。

目的

调查日本SPTCL患者的临床病理特征、治疗方式及预后。

材料与方法

我们对日本SPTCL病例进行了文献综述。

结果

英文和日文文献中共报道了22例。因缺乏足够的临床和免疫组织学数据排除了6例,16例有治疗方式及预后信息。日本病例的临床特征与西方国家总体相似。约一半的日本患者最初接受皮质类固醇治疗。其中,超过一半随后因疾病无反应或复发而接受化疗。总体而言,约80%的报道病例使用化疗作为一线或二线治疗。

结论

我们的研究结果表明,皮质类固醇可能对某些SPTCL患者有益,但大多数患者在病程中需要化疗。需要进一步研究以确立SPTCL的合适治疗策略并阐明预测因素,从而识别可能从皮质类固醇作为一线治疗中获益的患者。

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