亲毛囊性蕈样肉芽肿误诊1例

Misdiagnosis of Folliculotropic Mycosis Fungoides:A Case Report

患者女,80岁,全身红斑伴瘙痒2年余,加重1个月。曾误诊为嗜酸性粒细胞增多综合征并予治疗无效。组织病理示:淋巴细胞亲表皮现象,真皮层大量淋巴细胞浸润,少量嗜酸性粒细胞浸润。真皮血管、汗腺、皮脂腺等附属器大量淋巴细胞浸润。免疫组织化学染色示:CD3、CD4高表达,CD8少量表达,毛囊周围、皮脂腺周围大量CD4阳性细胞,汗腺周围少量CD4阳性细胞。诊断:亲毛囊性蕈样肉芽肿。治疗:予阿维A胶囊口服并随访中。

A 80-year-old female presented with systemic erythema and itch for more than two years,as aggravated for one month.It has been misdiagnosed as eosinophilia syndrome and has not been treated effectively.After visiting our hospital,the histopathological examination showed that lymphocyte pro-epidermal phenomena could be seen,a large number of lymphocytes infiltrated in the dermis,and a small number of eosinophil infiltrates.A large number of lymphocytes infiltrate the dermal blood vessels,sweat glands,sebaceous glands and other appendages.Immunohistochemistry examination showed the lymphocytes high expression of CD3 and CD4,small expression of CD8,a large number of CD4-positive cells around hair follicles and sebaceous glands,and a small number of CD4-positive cells around sweat glands.Diagnosis of follicular fungoides granuloma was made.Treated with orally acitretin and followed up were given.