淋巴瘤伴发皮肤肉芽肿的现象及其意义

Lymphoma-associated cutaneous granulomas

淋巴瘤可伴发皮肤肉芽肿，其模式主要有两种：一种是淋巴瘤的特异性皮损中出现肉芽肿反应，例如肉芽肿性蕈样肉芽肿和肉芽肿性皮肤松弛症；另一种是淋巴瘤出现非特异的肉芽肿性皮损，主要见于一些系统性淋巴瘤。其组织病理学类型可为结节病样、环状肉芽肿样、结核样等。其机制及其与预后的关系尚不明确。肉芽肿形成可能是造成某些淋巴瘤特殊临床表现的原因，也容易掩盖淋巴瘤的真实面目，在临床和组织学诊断上需谨慎。

Granuloma formation has been observed as an incidental histopathological phenomenon in several lymphoproliferative disorders. The patterns of cutaneous granulomas associated with lymphomas are classified into two types. The first type is characterized by granulomatous infiltrates admixed with neoplastic cells within specific skin lesions of lymphomas, such as granulomatous mycosis fungoides and granulomatous slack skin. The second type refers to unspecific granulomatous skin lesions commonly seen in systemic lymphomas. Histopathologically, these granulomas can be sarcoid-like, granuloma annulare-like, tuberculoid, and so on. The pathogenesis and prognostic significance of cutaneous granuloma need to be clarified. Granulomas can result in specific manifestations, and obscure the nature of lymphomas, hence, cautions should be given to clinical and histological diagnosis of cutaneous granulomas.