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Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides (MF).
Methods From January 2008 to January 2013, a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital. The median age of these patients was 53.36±14.45 years. Female-male ratio was 1:1.2. The average course of disease was 10.82±3.37 years. All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51 (40-74) Gy in an average of 24.55±5.57 (20-40) fractions, 5 fractions per week.
Results The median follow-up time was 55.27±29.3 (13-103) months. No severe acute or chronic side effects of irradiation were observed. Complete clinical response (CR) rate of the radiated sites was 54.5%(6/11), partial response (PR) rate was 36.4%(4/11), and the overall response rate (CR+PR) was 90.9%. One patient showed no response.
Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients. -
肉芽肿性蕈样肉芽肿一例
肉芽肿性蕈样肉芽肿(granuloma-tous mycosis fungoides,GMF)是蕈样肉芽肿(MF)的一种特殊的病理类型,其肉芽肿形成的病因学、发病机制及临床意义尚不清楚,预后也有争议.该病临床罕见,现遇一例报道如下.
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亲毛囊性蕈样肉芽肿伴嗜酸粒细胞增多一例
患者男,69岁。3年来,头、躯干和四肢出现散在红斑、毛囊性丘疹及痤疮样皮损(如粟丘疹、囊肿等)和脱发,病程中伴外周血嗜酸粒细胞增多。皮损组织病理检查示真皮内灶性慢性炎细胞浸润伴毛细血管增生,毛囊周围慢性炎细胞浸润伴血管增生,伴少许嗜酸粒细胞,考虑为毛囊炎,予抗组胺药和抗生素治疗后皮损炎症消退,瘙痒减轻。3个月后,枕部出现斑块伴脱发,组织病理检查示真皮内密集淋巴样细胞、嗜酸粒细胞浸润,毛囊周围大量淋巴样细胞浸润伴较多嗜酸粒细胞,可见不典型淋巴细胞,部分侵入毛囊,毛囊上皮黏液样变性。阿新蓝染色阳性。免疫组化染色:CD20、CD79a、EB病毒(EBV)、CD56、磷酸葡萄糖变位酶-1(PGM-1)、髓过氧化物酶(MPO)、CD7、抗角蛋白单克隆抗体AE1/AE3均阴性,异形细胞CD3、CD4、CD5、CD2、CD43、泛素羧基末端水解酶-L1 (UCHL-1)均阳性。T细胞受体基因重排结果为阴性。诊断:亲毛囊性蕈样肉芽肿。予光化学疗法(PUVA)联合阿维A治疗,仍有新发皮损,目前患者在随访中。