中华皮肤科杂志 ›› 1997, Vol. 30 ›› Issue (4): 237-239.

• 论著 • 上一篇    下一篇

成人T细胞白血病/淋巴瘤与皮肤淋巴瘤的鉴别

汪晨1, 陈国敏2, 马一盖1, 罗羽1, 姚志远1, 李静1, 何静文1, 陈锡唐1, 张永利2, 曾毅2   

  1. 1. 中日友好医院, 北京 100029;
    2. 中国预防医学科学院病毒学研究所
  • 收稿日期:1996-07-07 修回日期:1996-11-14 出版日期:1997-08-15 发布日期:1997-08-15

Distinction Between Adult T-cell Leukemia/Lymphoma and Cutaneous Lymphoma

Wang Chen1, Chen Guomin2, Ma Yigai1   

  1. Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029
  • Received:1996-07-07 Revised:1996-11-14 Online:1997-08-15 Published:1997-08-15

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摘要： 伴皮肤损害的成人T细胞白血病/淋巴瘤(ATLL)与皮肤T细胞淋巴瘤有极相似的临床病理和免疫分型,为了区别两者,对4例伴皮肤损害的ATLL和18例皮肤淋巴瘤进行临床病理、免疫学分型及嗜人T淋巴细胞病毒Ⅰ型(HTLV-Ⅰ)前病毒DNA的比较性研究,2例光线性类网织细胞增多症和2例皮肤淋巴细胞浸润症为阴性对照。结果:4例ATLL出现皮肤损害的同时表现系统症状如:广泛的浅淋巴结肿大,乳酸脱氢酶和白介素2受体异常增高,外周血有花瓣样细胞和骨髓异常。其外周血、骨髓、皮肤和淋巴结的HTLV-1前病毒DNA均阳性,而18例皮肤淋巴瘤均阴性。提示:具有皮肤T细胞淋巴瘤样的皮疹和病理模型及免疫分型同时伴周围血花瓣样细胞和HTLV-1阳性者应诊断本病。

关键词: 成人T细胞白血病/淋巴瘤, 淋巴瘤, 皮肤, HTLV-Ⅰ前病毒DNA

Abstract: Adult T-cell leukemia/lymphoma (ATLL) and cutaneous T-cell lymphoma (CTCL) have similar clinieopathology and immunophenotype, in order to differentiate the two diseases, 4 eases of ATLL associated cutaneous lesions and 18 eases of CL were studied for elinieopathology, immunophenotype and HTLV-I provirus DNA. Two eases of actinic reticuloid and two eases of lymphocytic infiltration of the skin were selected as negative control. The results showed that four patients of ATLL manifested cutaneous lesions, at same time, they had additional systemic diseases, such as generalized lymphadenopathy, increased levels of LDH and IL-2R, rosette-like cells in their peripheral blood and abnormal bone marrow. The HTLV-I provirus DNA was detected in the peripheral blood, bone marrow, cutaneous lesions and lymph node biopsy specimens of the four patients by PCR amplification of specific HTLV-I DNA fragment. 18 cases of CL were negative for HTLV-I. The study indicates that ATLL may be diagnosed if the patients are associated with CTCL-Iike cutaneous lesions, characteristic histopathological pattern and immunophenotype, rosette-like cells in the peripheral blood and positive HTLV-I provirus DNA.

Key words: Adult T cell leukemia/lymphoma, Lymphoma, cutaneous, HTLV-I provirus, DNA