Busch Caleb, Hashida Noriyasu, Nishida Kohji
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Am J Ophthalmol Case Rep. 2018 Jun 20;11:95-97. doi: 10.1016/j.ajoc.2018.06.008. eCollection 2018 Sep.
To report a case of corneal infiltration and xanthoma formation in mycosis fungoides (cutaneous T-cell lymphoma).
A middle aged Japanese man with mycosis fungoides (MF) involving the face was referred to Ophthalmology for evaluation of unilateral, painless conjunctival injection. Biopsy of the conjunctiva revealed a malignant T cell population consistent with MF tumor invasion. Years later, he returned following several episodes of infectious keratitis with a painless, yellow, rapidly forming mass in the left eye over two weeks. Corneal biopsy showed foamy histiocytes and positive staining for CD68, and a diagnosis of corneal xanthoma was made.
Severe ocular surface disease can rarely occur in MF by direct invasion of tumor cells. Corneal infiltration and xanthoma development may be avoidable by careful monitoring for infectious keratitis in patients with conjunctival involvement, as in our case.
报告1例蕈样肉芽肿（皮肤T细胞淋巴瘤）合并角膜浸润及黄瘤形成的病例。
1名患有累及面部的蕈样肉芽肿（MF）的中年日本男性因单侧无痛性结膜充血而转诊至眼科进行评估。结膜活检显示存在与MF肿瘤浸润一致的恶性T细胞群。数年后，他在经历几次感染性角膜炎发作后复诊，左眼出现一个无痛性、黄色、在两周内迅速形成的肿物。角膜活检显示有泡沫状组织细胞且CD68染色呈阳性，诊断为角膜黄瘤。
肿瘤细胞直接侵袭导致的严重眼表疾病在MF中很少见。如我们的病例所示，对于结膜受累的患者，通过仔细监测感染性角膜炎，角膜浸润和黄瘤的发生可能是可以避免的。
