淋巴瘤样丘疹病继发蕈样肉芽肿:共同T细胞克隆增生一例报告

A Case Report of Lymphomatoid Papulosis Followed By Mycosis Fungoides:Derived from a Com-mon T Cell Clone

目的报道一例淋巴瘤样丘疹病(LyP)继发蕈样肉芽肿(MF),随访27年,并检测其克隆性是否与疾病相关。方法比较不同时期的皮肤组织病理和免疫表型特点,同时应用聚合酶链反应(PCR)和Southern印迹杂交法,检测皮损组织和外周血标本的T细胞受体基因重排。结果此例在不同时期各具临床病理学特征,增生的淋巴细胞为成熟的Th细胞,且示共同T细胞克隆。结论LyP继发MF示相同T细胞克隆,克隆性T细胞与疾病的生物行为无关。

Objective To report a case of lymphomatoid papulosis(LyP)followed by mycosis fun-goides(MF)during his27years course and determine whether these diseases are clonally related.Methods Characteristics of clinicopathology and immunophenotype of skin tissues of different phases of the patients were compared.Simultaneously,clonal T-cell receptor gene rearrangement of skin lesion tissues and blood specimens were detected by means of polymerase chain reaction and Southern blot analysis.Results A dis-tinct clinical and pathological feature was shown in this case of LyP followed by MF.The proliferating lym-phocytes in LyP and MF were mature T helper lymphocytes,and with same T-cell clone.Conclusion LyP followed by MF displays a same T-cell clone.The clonal T-cell is irrelevant to the biological behavior of these diseases.