CAJ | 학술논문

目的进一步阐述原发性皮肤侵袭性亲表皮性CD8+细胞毒性T细胞淋巴瘤的发病特点、诊断、治疗及预后.方法对1例原发性皮肤侵袭性亲表皮性CD8+细胞毒性T细胞淋巴瘤患者的发病特点、诊断、治疗经过进行总结,并结合文献复习,进一步总结诊治经验.结果中年男性患者,因四肢、躯干反复发作渗出性斑丘疹1年余就诊,经皮肤活组织检查、免疫组织化学、T细胞基因重排、PET-CT检查,确诊为原发性皮肤侵袭性亲表皮性CD8+细胞毒性T细胞淋巴瘤T2N0M0Ⅰ期.经过鸦胆子油乳联合GDP方案化疗的中西医结合治疗,疗效评估达完全缓解,仍在继续治疗、随访中.结论原发性皮肤侵袭性亲表皮性CD8+细胞毒性T细胞淋巴瘤临床罕见,早期诊断困难,病理组织检查联合T细胞基因重排可确诊.为避免误诊,应认真询问病史,仔细查体,对反复发作迁延不愈的皮损要及早行病灶活组织检查,同时行免疫组织化学检查以及时诊断,为下一步治疗提供良好的基础.
목적 진일보천술원발성피부침습성친표피성CD8+세포독성T세포림파류적발병특점、진단、치료급예후.방법 대1례원발성피부침습성친표피성CD8+세포독성T세포림파류환자적발병특점、진단、치료경과진행총결,병결합문헌복습,진일보총결진치경험.결과 중년남성환자,인사지、구간반복발작삼출성반구진1년여취진,경피부활조직검사、면역조직화학、T세포기인중배、PET-CT검사,학진위원발성피부침습성친표피성CD8+세포독성T세포림파류T2N0M0Ⅰ기.경과아담자유유연합GDP방안화료적중서의결합치료,료효평고체완전완해,잉재계속치료、수방중.결론 원발성피부침습성친표피성CD8+세포독성T세포림파류림상한견,조기진단곤난,병리조직검사연합T세포기인중배가학진.위피면오진,응인진순문병사,자세사체,대반복발작천연불유적피손요급조행병조활조직검사,동시행면역조직화학검사이급시진단,위하일보치료제공량호적기출.
Objective To further elaborate the clinical characteristics,diagnosis,treatment and prognosis of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma.Methods The clinical characteristics,diagnosis and treatment of a patient with primary cutaneous invasive epidermotropic CD8 positive cytotoxicity T-cell lymphoma were summarized,and diagnosis and treatment of the disease from published literature were reviewed.Results After one year long,recurrence of exudative maculopapule on his body and limbs,a middle-aged male patient visited our hospital.Then,the patient was diagnosed as T2N0M0 Ⅰ phase of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma based on results of skin biopsy,immunohistochemistry,T-cell gene rearrangement and PET-CT.Through integrative medicine treatment (combination of bruceolic oil emulsion and chemotherapy with GDP regimen),the patient achieved complete remission (CR).The treatment and follow-up continues till now and his condition was stable.Conclusions Clinical occurrence of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma is rare and early diagnosis is difficult.It could be diagnosed with histopathology combined with T-cell gene rearrangement.In order to avoid misdiagnosis,great caution should be taken during disease history inquiry and physical examination,should be early lesion for delayed healing of recurrent lesions,biopsy should be conducted as soon as possible and immunohistochemistry should be performed simultaneously,which will provide a good basis for further treatment.