肉芽肿性松弛皮肤特殊类型的蕈样肉芽肿一例

Granulomatous Slack Skin: A Case Report

目的报告一例蕈样肉芽肿之极其罕见的肉芽肿性皮肤松弛。方法对其临床、组织病理、免疫组化、超微结构和分子生物学进行研究。结果在皮肤肿块内致密淋巴细胞、组织细胞和多核巨细胞浸润，少数淋巴细胞向表皮性。弹性纤维几乎完全消失。免疫组化示淋巴细胞表达CD3，CD45RO。分子生物学检查示T细胞受体β链基因重排。超微结构示巨噬细胞有许多绒毛样结构和溶酶体。结论此例为一种罕见变异的蕈样肉芽肿。

Objective To report a case of granulomatous slack skin which is an extremely uncommon variant of mycosis fungoides. Methods The clinical, histopathologic, immunologic, ultrastructural and molecular biologic changes of the disease were evaluated. Results A massive dermal infiltration composed of Iymphocytes intermingled with numerous histiocytes and multinucleated giant cells was found. A few Iymphocytes showed mild epidermotropism. There was almost complete loss of elastic fibers. The lymphocytes were of T-lineage (CD3+, CD45RO + ). The rearrangement of the T-cell-receptor beta chain was identified hy molecular hiologic study. Ultrastructurally, there were macrophages with numerous surface villous processes and lysosomes.Conclusion This is the first case repori of granulomatous slack skin in China and the defined raised border of skin lesions has been emphasized.[