Composite B-cell and T-cell lineage post-transplant lymphoproliferative disorder of the lung with unusual cutaneous manifestations of mycosis fungoides.
Composite B-cell and T-cell lineage post-transplant lymphoproliferative disorder of the lung with unusual cutaneous manifestations of mycosis fungoides.
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复合 B 细胞和 T 细胞谱系移植后肺部淋巴增殖性疾病，伴有蕈样肉芽肿的不寻常皮肤表现。
DOI：
10.1097/dad.0b013e31823067f8
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Pang,ChangleeS
中科院分区：
文献类型：
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作者：
Mills,KyleC;Sangüeza,OmarP;Beaty,MichaelW;Raffeld,Mark;Pang,ChangleeS
我们提出的情况下，17岁的男性肾移植受者谁提出最初的皮肤症状，并发现有组织学变化的皮肤符合蕈样肉芽肿。诊断后不久，影像学检查显示双肺多灶性间质和肺泡实变。体格检查未发现淋巴结病或肝脾肿大，但开放性肺活检显示EB病毒（EBV）阴性单形性T细胞移植后淋巴组织增生性疾病（PTLD）伴EBV阳性B细胞PTLD，涉及相同的肺部病变。聚合酶链反应分析表明，在皮肤和肺活检克隆T细胞受体基因重排。有趣的是，1个克隆在皮肤和肺之间共享，而第二个克隆仅存在于肺中。据我们所知，这是第一个报告的情况下，PTLD提出的皮肤，其中有一个随后发现的复合，双线性B细胞和T细胞PTLD的肺。
We present the case of a 17-year-old male kidney transplant recipient who presented initially with dermatologic symptoms and was found to have histologic changes in the skin that were consistent with mycosis fungoides. Shortly after this diagnosis was made, imaging studies demonstrated multifocal interstitial and airspace consolidation in both lungs. Physical examination revealed no lymphadenopathy or hepatosplenomegaly, but an open lung biopsy revealed an Epstein–Barr virus (EBV)-negative monomorphic T-cell posttransplant lymphoproliferative disorder (PTLD) with a concomitant EBV-positive B-cell PTLD involving the same lesion of the lung. Polymerase chain reaction analysis demonstrated clonal T-cell receptor gene rearrangements in both the skin and the lung biopsies. Interestingly, 1 clone was shared between the skin and lung while a second clone was present only in the lung. To our knowledge, this is the first reported case of a PTLD presenting in the skin in which there was a subsequent discovery of composite, bilineal B-and T-cell PTLD of the lung.