中华皮肤科杂志 ›› 2005, Vol. 38 ›› Issue (4): 205-207.

• 论著 • 上一篇    下一篇

中国人皮肤型成人T细胞白血病/淋巴瘤一例报道

高红阳1, 邱丙森2, 王平3, 陈明华2, 单易非1   

  1. 1. 复旦大学上海医学院分子生物学室 上海 200032;
    2. 复旦大学附属华山医院皮肤病学研究所;
    3. 东南大学中大医院皮肤科
  • 收稿日期:2004-05-22 出版日期:2005-04-15 发布日期:2005-04-15
  • 通讯作者: 邱丙森,E-mail:qiubingsen@yahoo.com.cn E-mail:qiubingsen@yahoo.com.cn

Cutaneous Type Adult T-cell Leukemia/Lymphoma: The First Case Report in China

GAO Hong-yang1, QIU Bing-sen2, WANG Ping3, CHEN Ming-hua2, SHAN Yi-fei1   

  1. 1. Lab of Molecular Biology, Shanghai Medical College, Fudan University, Shanghai 200032, China;
    2. Institute of Dermatology, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Received:2004-05-22 Online:2005-04-15 Published:2005-04-15

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摘要： 目的 报道1例皮肤型成人T细胞白血病/淋巴瘤(cATLL)。方法 检测皮肤损害的组织病理、直接免疫荧光和免疫表型的特点,同时应用酶联免疫吸附试验、蛋白印迹法以及聚合酶链反应分别检测患者外周血中嗜人T淋巴细胞病毒Ⅰ型(HTLV-Ⅰ)抗体和淋巴样细胞的HTLV-Ⅰ前病毒DNA。结果 此例患者的皮肤损害多形,除表现丘疹、斑块外,并发生疱壁紧张或松弛的大疱。组织病理检查示表皮下水疱,疱底真皮乳头和疱边缘处小至中等大不典型淋巴样细胞浸润。不典型淋巴样细胞示CD45+、CD45RO+,直接免疫荧光检查阴性。外周血中HTLV-Ⅰ抗体阳性;淋巴样细胞中HTLV-Ⅰ前病毒DNA阳性。患者最后死亡,病程1年10个月。结论 ATLL在我国并非极罕见,cATLL也存在,应加以警惕。

关键词: 白血病淋巴瘤, T细胞, 急性, HTLV-Ⅰ相关

Abstract: Objective To report the first case of cutaneous type adult T-cell leukemia/lymphoma(cATLL) in China. Methods The skin lesion was examined by histopathology and direct immunofluorescence (DIF), and the immunophenotype was also studied. ELISA and Western blot were used to test the serum antibodies to HTLV-Ⅰ, and HTLV-Ⅰproviral DNA of lymphoid cells was detected by PCR. Results The patient had polymorphic skin lesions including papules, plaques, and bullae with tense or flaccid walls. Histopathogical examination showed subepidermal bullae, and there were small-to-medium-sized atypical lymphoid cell infiltrations in the dermal papilla in the bottom, and border of the bulla. CD45+ and CD45RO+ staining, and negative DIF were observed in the atypical lymphoid cells. The serum antibodies to HTLV-Ⅰ, and proviral DNA of HTLV-Ⅰin the blood lymphoid cells were detected. The patient died with a disease course of one year and ten months. Conclusion ATLL is not extremely rare in China, and cATLL may also exist.

Key words: Leukemia-lymphoma, T-cell, acute, HTLV-Ⅰ-associated