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播散性蕈样肉芽肿病型 D 于一位梅斯蒂索人患者。

Lymphomatoid Papulosis Type D in a Mestizo-Ancestry Man.

机构信息

Service of Dermatology, Hospital General de México "Dr. Eduardo Liceaga," S.S./School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; and.

Department of Pathology, Hospital Universitario de San Luis Potosí, SLP, México.

出版信息

Am J Dermatopathol. 2024 Nov 1;46(11):766-770. doi: 10.1097/DAD.0000000000002826. Epub 2024 Sep 17.

Abstract

Lymphomatoid papulosis (LyP) belongs to the CD30 + skin lymphoproliferative disorders; it is defined as a chronic, recurrent, self-healing eruption of papules and small nodules with the histopathologic features of a cutaneous T-cell lymphoma. It is classified according to histopathology into subtypes A to F and with chromosomal rearrangement 6p25.3. Type D is characterized by epidermotropism of atypical CD8 + and CD30 + lymphocytes, small to medium size, forming papules and nodules with erosion and necrosis, which represents a formidable challenge in the differential diagnosis with aggressive cutaneous cytotoxic lymphomas. We present the clinical case of a 22-year-old man with subacute dermatosis, who underwent a skin biopsy with a report of LyP. Immunohistochemistry showed negative CD4, CD5, granzyme-B markers and positive CD3, CD30, CD8, CD56, and (T-cell intracellular antigen 1) TIA-1 markers, concluding the diagnosis of type D LyP. The course of the disease is recurrent; however, the prognosis is good with a 10-year survival of 100%. We present the case of a mestizo-ancestry patient who developed a type-D LyP, and, to the best of our knowledge, there are no publications of type D LyP from Latin-American authors or about mestizo-ancestry (or hispanic) patients; therefore, we consider of relevance to inform about these findings.

摘要

蕈样肉芽肿(LyP)属于 CD30+皮肤淋巴增生性疾病;它被定义为一种慢性、复发性、自限性的丘疹和小结节发作,具有皮肤 T 细胞淋巴瘤的组织病理学特征。它根据组织病理学分为 A 至 F 型,并伴有染色体重排 6p25.3。D 型的特征是表皮亲嗜性的不典型 CD8+和 CD30+淋巴细胞,小至中等大小,形成丘疹和结节,伴有糜烂和坏死,这在与侵袭性皮肤细胞毒性淋巴瘤的鉴别诊断中极具挑战性。我们报告了一例 22 岁男性亚急性皮肤病患者的临床病例,该患者接受了皮肤活检,报告为 LyP。免疫组织化学显示 CD4、CD5、颗粒酶-B 标志物阴性,CD3、CD30、CD8、CD56 和(T 细胞内抗原 1)TIA-1 标志物阳性,诊断为 D 型 LyP。疾病的病程是复发性的;然而,预后良好,10 年生存率为 100%。我们报告了一例混血患者发生 D 型 LyP 的病例,据我们所知,尚无拉丁美洲作者或关于混血(或西班牙裔)患者的 D 型 LyP 出版物;因此,我们认为告知这些发现很重要。

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