CAJ | 학술논문

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一5 cm×7 cm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,部分细胞侵入表皮形成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、CD79α、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.
환자남,42세,우측흉배부무명현자각증상적침윤성담홍반반월여,피진완만확대.피부과검사:우측흉배부액후선견갑골하방일5 cm×7 cm변계모호적침윤성담홍반.피손조직병리검사:진피천층급중하부효원섬유속간교다단일핵세포침윤,부분세포침입표피형성Pautrier미농종,부분세포유경도이형.면역조화염색:단일핵세포CD3、CD5、CD8、CD45Ro、세포독과립상관단백(TIA-1)균양성(+),CD4산재양성(+),CD7、CD20、CD30、CD56、CD68、CD79α、립매B균음성,Ki67양성＞20％,T세포수체중배검측음성.진단:단일손해적간질성심양육아종.
A 42-year-old man presented with a slowly spreading,asymptomatic,infiltrated erythematous patch in the fight side of the chest and back for more than half a month.Dermatologic examination revealed a poorly marginated,pink infiltrated patch sized 5 cm × 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 microabscesses.Mild atypia was observed in some infiltrating mononuclear cells.Immunohistochemistryshowed that the mononuclear cells were positive for CD3,CD4 (scattered),CD5,CD8,CD45Ro,the cytotoxicgranule-associated protein TIA-1,but negative for CD7,CD20,CD30,CD56,CD68,CD79α,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.