Diette K M, Caro W A, Roenigk H H
J Am Acad Dermatol. 1984 May;10(5 Pt 2):896-902. doi: 10.1016/s0190-9622(84)80442-9.
A 49-year-old man with fever, malaise, weight loss, and pneumonia developed cutaneous nodules and neurologic symptoms. Skin biopsy studies revealed granulomatous inflammation consistent with a sarcoid reaction, and mild granulomatous changes were noted on biopsy specimens of liver and bone marrow. A lymph node biopsy was unremarkable. Neurologic deterioration prompted an extensive workup that revealed an intracranial mass. A brain biopsy study revealed malignant lymphoma, large cell type. Autopsy study confirmed the diagnosis and showed no evidence of granulomatous infiltrates. The cutaneous granulomas represent a nonspecific immune response possibly related to the underlying lymphoma. The relationship between sarcoidosis and sarcoid reactions and lymphoma is discussed.
一名49岁男性，伴有发热、乏力、体重减轻和肺炎，出现了皮肤结节和神经系统症状。皮肤活检显示肉芽肿性炎症，符合结节病反应，肝脏和骨髓活检标本显示轻度肉芽肿性改变。淋巴结活检无明显异常。神经系统恶化促使进行了全面检查，发现颅内有肿块。脑活检显示为大细胞型恶性淋巴瘤。尸检证实了诊断，且未发现肉芽肿浸润的证据。皮肤肉芽肿代表一种可能与潜在淋巴瘤相关的非特异性免疫反应。本文讨论了结节病、结节病反应与淋巴瘤之间的关系。
