Moreau-Cabarrot A, Bonafé J L, Gorguet B, Andrieu H, Massip P
Service de Dermatologie, CHU de Rangueil, Toulouse.
Ann Dermatol Venereol. 1994;121(10):727-30.
The association between lymphomatoid papulosis and malignant Hodgkin or non-Hodgkin lymphoma is well known but still raises the problem of nosology between these two pathologies. Is lymphomatoid papulosis a pseudolymphoma, a prelymphomatous state or a true skin lymphoma?
We observed a patient who had lymphomatoid papulosis and anaplastic large-cell lymphoma within an interval of 8 years between. This case was particularly interesting because identical immunophenotypes were observed in the atypical large-cells of the skin and the lymphomatous cells of the lymph nodes (positive for CD43, CD45, CD25, CD30, CD15, EMA).
This case points out that atypical large-cells of lymphomatoid papulosis express the CD15 antigen which is only expressed by atypical large-cells in half of the cases of lymphomatoid papulosis. In addition, EMA is classically expressed in primary lymph node lymphomas rather than in primary cutaneous anaplastic large cell lymphomas which could predict extracutaneous dissemination of lymphomatoid papulosis. Furthermore, the demonstration that the skin lesions and the lymph nodes responded differently to the same treatment would suggest that there are other unrecognized biological differences. Lymphomatoid papulosis appears to be a range of disorders of the lymphoproliferation of activated T-cells and could include varioliform parapsoriasis and cutaneous lymphoma.
淋巴瘤样丘疹病与恶性霍奇金淋巴瘤或非霍奇金淋巴瘤之间的关联已为人熟知，但这两种病理状态之间的疾病分类问题仍然存在。淋巴瘤样丘疹病是假性淋巴瘤、淋巴瘤前期状态还是真正的皮肤淋巴瘤？
我们观察了一名患者，其在8年的间隔期内先后出现淋巴瘤样丘疹病和间变性大细胞淋巴瘤。该病例特别有趣，因为在皮肤的非典型大细胞和淋巴结的淋巴瘤细胞中观察到相同的免疫表型（CD43、CD45、CD25、CD30、CD15、EMA呈阳性）。
该病例指出，淋巴瘤样丘疹病的非典型大细胞表达CD15抗原，而在半数淋巴瘤样丘疹病病例中，CD15抗原仅由非典型大细胞表达。此外，EMA通常在原发性淋巴结淋巴瘤中表达，而非原发性皮肤间变性大细胞淋巴瘤，这可能预示着淋巴瘤样丘疹病会出现皮肤外播散。此外，皮肤病变和淋巴结对相同治疗反应不同的证据表明，还存在其他未被认识到的生物学差异。淋巴瘤样丘疹病似乎是一系列活化T细胞淋巴增殖性疾病，可能包括痘疮样副银屑病和皮肤淋巴瘤。
