Sheibani K, Forman S J, Winberg C D, Rappaport H
Blood. 1983 Dec;62(6):1176-81.
Although rare cases of chronic lymphocytic leukemia (CLL) of the T-cell type have been reported, CLL is more commonly found to be a neoplastic lymphoproliferative disease of B-cell origin. In this article, we describe a patient with long-standing CLL that was immunologically shown to be of the B-cell type, who, during the course of his disease, developed cutaneous T-cell lymphoma (CTCL), which was shown to be of the helper/inducer subtype. The neoplastic lymphoid cells in the skin infiltrate differed morphologically and immunologically from those in the peripheral blood. The occurrence of CTCL during this patient's clinical course represents a second neoplasm arising from a different cell line, rather than a tissue manifestation of the patient's CLL. To our knowledge, this is the first report in which the occurrence of CTCL is documented in a patient with immunologically known B-cell CLL. In addition to establishing the presence of B-cell CLL and CTCL of the helper/inducer T-cell type in the same patient, this case report demonstrates the usefulness and necessity of evaluating lymphoproliferative disorders by means of a multidisciplinary approach.
尽管已有T细胞型慢性淋巴细胞白血病（CLL）的罕见病例报道，但CLL更常见的是一种起源于B细胞的肿瘤性淋巴细胞增殖性疾病。在本文中，我们描述了一名患有长期CLL的患者，免疫检查显示为B细胞型，在其病程中发展为皮肤T细胞淋巴瘤（CTCL），显示为辅助/诱导亚型。皮肤浸润的肿瘤性淋巴细胞在形态和免疫方面与外周血中的不同。该患者临床病程中CTCL的出现代表了源自不同细胞系的第二种肿瘤，而非其CLL的组织表现。据我们所知，这是第一份记录了免疫已知的B细胞CLL患者发生CTCL的报告。除了证实同一患者存在B细胞CLL和辅助/诱导T细胞型CTCL外，本病例报告还证明了通过多学科方法评估淋巴细胞增殖性疾病的实用性和必要性。
