Gizewska-Kacprzak Kaja, Karpinska-Kaczmarczyk Katarzyna, Ociepa Tomasz
Department of Pediatric and Oncological Surgery, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Poland.
Department of Pathology, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Poland.
European J Pediatr Surg Rep. 2017 Jan;5(1):e68-e70. doi: 10.1055/s-0037-1607036. Epub 2017 Oct 28.
During infancy, skin inflammation is usually treated in basic pediatric care. In this study, we present a case of an 8-month-old girl with a 2-month history of an inflammation of the thigh treated locally by ointments and oral antibiotics in basic and dermatological care. The patient had a history of fever, sweating, and failure to thrive. The lactate dehydrogenase was elevated up to 869 U/L with low C-reactive protein (1.04 mg/L). Magnetic resonance imaging of the thigh reassured the diagnosis of local inflammation. Intravenous antibiotic caused mild local improvement, but the episodes of high fever sustained. The patient was transferred to our pediatric surgery department for treatment and surgical biopsy of the lesion. Histopathological examination confirmed a subcutaneous panniculitis-like T-cell lymphoma, which is a rare cytotoxic T-cell lymphoma representing less than 1% of non-Hodgkin lymphomas, uncommon in children. The patient was introduced to a chemotherapy protocol EURO-LB 2002 with good response. In a skin lesion that is associated with systemic symptoms and responding untypically to antibiotic treatment malignancy should be considered and biopsy not be postponed.
在婴儿期，皮肤炎症通常在基础儿科护理中进行治疗。在本研究中，我们报告了一例8个月大的女孩，其大腿炎症病史长达2个月，在基础护理和皮肤科护理中，局部使用药膏和口服抗生素进行治疗。该患者有发热、出汗和发育不良的病史。乳酸脱氢酶升高至869 U/L，而C反应蛋白水平较低（1.04 mg/L）。大腿的磁共振成像确诊为局部炎症。静脉使用抗生素使局部有轻度改善，但高热发作仍持续。该患者被转至我们的小儿外科进行治疗及对病变进行手术活检。组织病理学检查证实为皮下脂膜炎样T细胞淋巴瘤，这是一种罕见的细胞毒性T细胞淋巴瘤，占非霍奇金淋巴瘤的比例不到1%，在儿童中并不常见。该患者接受了EURO-LB 2002化疗方案，反应良好。对于伴有全身症状且对抗生素治疗反应不典型的皮肤病变，应考虑恶性肿瘤的可能，不应推迟活检。
