Sajben F P, Schmidt C
Department of Dermatology, Naval Medical Center, Pearl Harbor, Hawaii, USA.
Cutis. 1996 Oct;58(4):297-302.
Subcutaneous T-cell lymphoma is rare. Differentiation from several clinically similar entities such as malignant histiocytosis, histiocytic cytophagic paniculitis, Weber-Christian disease, and systemic lymphoma can be difficult. Our patient presented with plaquelike lesions on her lower extremities, fevers, hepatic dysfunction, and a laboratory-proven coagulopathy. Examination of a skin biopsy specimen revealed a benign-appearing histiolymphocytic infiltrate with panniculitis and erythrophagocytosis. Immuno-histochemical staining of the infiltrate demonstrated a predominance of T cells. At autopsy, an atypical T-cell infiltrate was noted in the skin, subcutis, and other organs. Subcutaneous T-cell lymphoma is a rare type of peripheral T-cell lymphoma whose diagnosis is problematic. Based on the initial difficulty finding the lymphomatous infiltrate in our case, it is conceivable that previously reported cases of histiocytic cytophagic panniculitis, malignant histiocytosis, and Weber-Christian disease were in fact unrecognized cases of lymphoma.
皮下T细胞淋巴瘤较为罕见。要将其与几种临床症状相似的疾病区分开来可能比较困难，比如恶性组织细胞增多症、组织细胞吞噬性脂膜炎、韦氏-克里斯蒂安病以及系统性淋巴瘤。我们的患者下肢出现斑块样病变、发热、肝功能障碍以及实验室确诊的凝血病。对皮肤活检标本的检查显示，有呈良性表现的组织细胞淋巴细胞浸润，并伴有脂膜炎和红细胞吞噬现象。对浸润组织进行免疫组化染色显示T细胞占优势。尸检时，在皮肤、皮下组织及其他器官发现了非典型T细胞浸润。皮下T细胞淋巴瘤是一种罕见的外周T细胞淋巴瘤，其诊断存在问题。鉴于我们病例中最初很难发现淋巴瘤浸润，可想而知，先前报道的组织细胞吞噬性脂膜炎、恶性组织细胞增多症及韦氏-克里斯蒂安病病例实际上可能是未被识别的淋巴瘤病例。
