皮肤CD8^＋亲表皮性T细胞淋巴瘤一例

A case of primary cutaneous CD8-positive epidermotropic T-cell lymphoma

75岁男性患者，躯干、四肢出现瘙痒性红斑、斑块和苔藓样皮疹5年。皮肤科检查：颈部、躯干和四肢泛发暗红、灰黑色浸润性斑片和斑块，以背部为甚。全身浅表淋巴结无肿大，未发现系统受累情况。组织病理显示：表皮不规则增生，棘层肥厚，表皮内可见核深染的异形淋巴细胞浸润，形成Pautrier微脓肿。真皮浅层有片状和团块状淋巴样细胞浸润，细胞有异形性。免疫组化标记：肿瘤细胞CD3、CD8、GrB、LCA和TIA-1阳性，CD4和CD5阴性。符合原发性皮肤CD8^＋亲表皮性T细胞淋巴瘤诊断。口服维胺酯治疗病情有所好转。

A 75-year-old man presented with a 5-year history of pruritic erythema, plaque and lichenification distributed on the trunk and extremities. Physical examination showed diffiasely dark-red and gray-black infiltrative erythema and plaque on the neck, trunk and extremities, especially on the upper back. No superficial lymphadenectasis or definite evidence of systemic involvement was observed. Histopathology of biopsy specimens revealed an irregular epidermal hyperplasia, acanthosis, dense and massive infiltrations of the upper dermis by and atypical lymphoidocytes with hyperchromatic nuclei which formed Pautrier microabcesses. There was patchy and lump-like lymphoid infiltration with atypical cells in the superficial dermis. Tumor cells were positive for CD3, CDS, granzyme B （GrB）, LCA and TIA-1, but negative for CD4 and CD5. A diagnosis of primary cutaneous CDg-positive epidermotropic T-cell lymphoma was made. Oral viaminate was effective in controlling the condition.