文献简介

出版社:JAMA

作  者:CarolynM.Stull,MD;LukeWallis,MD;ClaudiaHernandez,MD

编  号:

关键字:狮面相;套细胞淋巴瘤

年  份:2021   点击量:77

文献摘要 全文翻译

A man in his 60s presented as a transfer from an outside hospital. The division of dermatology was consulted for evaluation of lesions on the face, chest, back, and arms that were gradually increasing in size and number over the past year. Physical examination revealed leonine facies with madarosis and an eschar on the nasal dorsum (Figure, A). Red-to-brown dome-shaped papules coalescing into plaques were present on the upper extremities. The lesions were nontender and nonpruritic. Cervical and axillary lymph nodes were palpable. The patient had a muffled voice and reported shortness of breath with exertion. Results of laboratory investigation demonstrated marked leukocytosis with a white blood cell count of 77.5×103 /uL with 76.5% lymphocytes. No blasts were present on peripheral smear. Computed tomography of the chest, abdomen, and pelvis demonstrated multiple enlarged mediastinal, axillary, subpectoral, abdominopelvic, and inguinal lymph nodes. Small pulmonary nodules were also detected. A punch biopsy was obtained from the right arm (Figure, B ,C, and D).

患者男性,60余岁,转院患者。患者就诊皮肤科以评估过去几年面部胸部背部和手臂逐渐增大、增多的皮损。体格检查发现,样面容伴睫毛脱落和鼻背部焦痂(图A)。上肢出现红褐色圆顶状丘疹融合斑块。皮损不痛不痒。可扪及颈、腋淋巴结。该患者声音低沉,呼吸急促,困难。实验室研究结果表明,白细胞显著增多,白细胞计数77.5×10 3 / uL,淋巴细胞为76.5%。外周血涂片未见原始细胞。胸部,腹部和骨盆的计算机断层扫描显示多个扩大纵隔,腋窝,胸下,腹盆腔和腹股沟淋巴结肿大。同时发现肺小结节。右臂穿刺活检(B、CD)