皮膚T細胞性リンパ腫─臨床経過と検査所見が非特異的で診断に苦慮した例─

・四肢・体幹に紅斑や丘疹，結節のほか，腫瘤を認める臨床像でありながら，病理組織学的に小型の異型の乏しいリンパ球浸潤であり，古典的菌状息肉症の腫瘤期としては非特異的であり，診断に苦慮した皮膚T細胞性リンパ腫（cutaneous T-cell lymphoma：CTCL）の1例を経験した． ・ステロイド外用療法，光線療法で治療を開始したが改善に乏しく，ベキサロテン内服治療により皮疹の改善を認めた． （「症例のポイント」より）

A diagnostically challenging case of cutaneous T-cell lymphoma Saito, Sonoko1）Kurihara, Yuichi1）Hirai, Ikuko1）Nakamura, Yoshio1）Ebihara, Tamotsu1）Funakoshi, Takeru1） 1）Department of Dermatology, Keio University School of Medicine Abstract A 37-year-old man with a 10-year-history of recurrent erythema on his abdomen and 1 -year history of systemic nodules and ulcerations was admitted to our hospital. The physical examination revealed ulcerated nodules and plaques involving the trunk and extremities. Histopathological findings showed dense lymphocytic infiltration with epidermotropism around the dermis. Monoclonality of the TCR gene rearrangement was not observed. Based on clinical and histopathological findings, he was diagnosed with cutaneous T-cell lymphoma (CTCL). Oral bexarotene therapy was initiated, and he showed remarkable improvement. Diagnosing CTCL is sometimes challenging, and clinical evaluation with laboratory test findings are beneficial for CTCL diagnosis.