单一损害的间质性蕈样肉芽肿一例

Unilesional interstitial mycosis fungoides： a case report

患者男，42岁，右侧胸背部无明显自觉症状的浸润性淡红斑半月余，皮疹缓慢扩大。皮肤科检查：右侧胸背部腋后线肩胛骨下方-5cm×7cm边界模糊的浸润性淡红斑。皮损组织病理检查：真皮浅层及中下部胶原纤维束间较多单一核细胞浸润，部分细胞侵人表皮形成Pautrier微脓肿，部分细胞有轻度异形。免疫组化染色：单一核细胞CD3、CD5、CD8、CD45Ro、细胞毒颗粒相关蛋白（TIA-1）均阳性（＋），CD4散在阳性（＋），CD7、CD20、CD30、CD56、CD68、CD79a、粒酶B均阴性，Ki67阳性〉20％，T细胞受体重排检测阴性。诊断：单一损害的间质性蕈样肉芽肿。

A 42-year-old man presented with a slowly spreading, asymptomatie, infiltrated erythematous patch in the right side of the chest and back for more than half a month. Dermatologic examination revealed a poorly marginated, pink infiltrated patch sized 5 cm x 7 cm in the right subscapular region of the back and chest. Histopathologically, there was an infiltrate of numerous mononuclear cells in the superficial dermis as well as between collagen fibers in the middle and deep dermis, with epidermotropism of some cells and formation of Pautrier＇s mieroabscesses. Mild atypia was observed in some infiltrating mononuelear cells. Immunohistochemistry showed that the mononuclear cells were positive for CD3, CD4 （scattered）, CD5, CDS, CD45Ro, the cytotoxicgranule-associated protein TIA-1, but negative for CD7, CD20, CD30, CD56, CD68, CD79a, and granzyme B, with the percentage of Ki-67-positive cells higher than 20%. T cell receptor （TCR） rearrangement was negative. The final diagnosis was unilesional interstitial mycosis fungoides.