肿瘤细胞治疗研究
英文原题：A Case of CD4 + T-Cell Lymphoma With Gamma-Delta Phenotype, Incidentally Manifesting in a Wound Debridement Sample.
A Case of CD4 + T-Cell Lymphoma With Gamma-Delta Phenotype, Incidentally Manifesting in a Wound Debridement Sample.
我们报告一位85岁男性患者，其病史中银屑病具有显著意义，因大腿伤口在9个月内缓慢扩大而就诊。
我们报告一例85岁男性患者，既往有银屑病病史，因大腿伤口在9个月内缓慢扩大就诊。该患者此前因骨髓炎接受过手指截肢治疗。组织样本的组织学检查显示广泛溃疡形成，伴大面积坏死延伸至皮下组织。标本边缘还显示皮下脂肪组织中有结节性淋巴样浸润，由非典型细胞组成。这些细胞仅对CD3、CD4和T细胞受体（TCR）delta染色呈阳性。肿瘤细胞的Ki-67增殖指数约为70%。肿瘤细胞对CD30、CD8、CD56、TCR BF1、颗粒酶、TIA1、CD123和Epstein-Barr编码区（EBER）-ish染色呈阴性。诊断为gamma-delta T细胞淋巴瘤。进一步影像学检查显示区域淋巴结肿大。患者开始接受mini-CHOP和非格司亭治疗；然而，患者在诊断后1个月内死亡。这是一例有趣的gamma-delta T细胞淋巴瘤病例，是在慢性伤口上偶然诊断的。此外，它显示出CD4+、CD8-表型，这在gamma-delta表型的T细胞淋巴瘤中极为罕见。
We report an 85-year-old male patient with a medical history significant for psoriasis who presented with a thigh wound that expanded slowly over the course of 9 months. The patient was previously treated with amputation of hand digits for osteomyelitis. Histologic examination of the tissue sample revealed a broad ulceration with large areas of necrosis extending into the subcutis. The edge of the specimen also revealed a nodular lymphoid infiltrate in the subcutaneous adipose tissue composed of atypical cells. These cells were only positive for CD3, CD4, and T-cell receptor (TCR) delta stains . The Ki-67 proliferation index of tumor cells was about 70%. The tumor cells were negative for CD30, CD8, CD56, TCR BF1, granzyme, TIA1, CD123, and Epstein-Barr encoding region (EBER)-ish stains. A diagnosis of gamma-delta T-cell lymphoma was made. Further imaging showed regional lymphadenopathy. The patient was started on mini-CHOP and filgrastim; however, the patient died within 1 month after the diagnosis. This is an interesting case of gamma-delta T-cell lymphoma that was incidentally diagnosed on a chronic wound. In addition, it showed a CD4 + , CD8 - phenotype that is exceedingly rare for T-cell lymphomas with gamma-delta phenotype.
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