皮肤血管免疫母细胞 T 细胞淋巴瘤：EB 病毒阳性及其对临床病理特征的影响。

Cutaneous angioimmunoblastic T-cell lymphoma: Epstein-Barr virus positivity and its effects on clinicopathologic features.

机构信息

Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

J Am Acad Dermatol. 2019 Oct;81(4):989-997. doi: 10.1016/j.jaad.2018.08.053. Epub 2018 Sep 18.

DOI:10.1016/j.jaad.2018.08.053

PMID:30240776

Abstract

BACKGROUND

Epstein-Barr virus (EBV) positivity frequently presents in patients with nodal angioimmunoblastic T-cell lymphoma (AITL). However, the presence of EBV in skin lesions and its clinicopathologic significance have not been evaluated.

OBJECTIVE

To analyze the clinical and histopathologic features of cutaneous AITL and evaluate EBV positivity in skin tissue and its effects on clinicopathologic features of AITL.

METHODS

Clinicopathologic variables in patients with cutaneous AITL were analyzed and compared depending on EBV in situ hybridization status in skin lesions by using patients' medical records.

RESULTS

Of the 86 patients with AITL, 42 had a cutaneous presentation. In situ hybridizations positive for EBV were noted in 19 of 42 patients with cutaneous AITL. EBV positivity was more common in papular and nodular skin lesions than other cutaneous morphologies, such as nonspecific rash or purpuric patches. An EBV-positive in situ hybridization was associated with a pattern of dense, superficial and deep infiltrates of pleomorphic, large-sized, atypical lymphocytes. EBV positivity in skin lesions was an independent negative prognostic factor in patients with AITL.

LIMITATIONS

Retrospective study at a single institution.

CONCLUSION

EBV-positive cutaneous AITL is associated with distinctive clinicopathologic features.

摘要

背景

EB 病毒（EBV）阳性在结内血管免疫母细胞性 T 细胞淋巴瘤（AITL）患者中经常出现。然而，皮肤病变中 EBV 的存在及其临床病理意义尚未得到评估。

目的

分析皮肤 AITL 的临床和组织病理学特征，并评估皮肤组织中 EBV 阳性及其对 AITL 临床病理特征的影响。

方法

通过患者病历，根据皮肤病变中 EBV 原位杂交状态分析和比较具有皮肤 AITL 的患者的临床病理变量。

结果

在 86 例 AITL 患者中，有 42 例有皮肤表现。在 42 例皮肤 AITL 患者中，有 19 例 EBV 原位杂交阳性。与其他皮肤形态（如非特异性皮疹或瘀斑）相比，EBV 阳性在丘疹和结节性皮肤病变中更为常见。EBV 阳性原位杂交与密集、表浅和深部浸润的多形性、大型、非典型淋巴细胞模式相关。皮肤病变中的 EBV 阳性是 AITL 患者独立的不良预后因素。