Report 1 case of lymphoma papulosis and literature review

QIAO Li; LI Xinji; LIU Yan; LIU Wen; LI Fei

Abstract：Objective To investigate the etiology, diagnosis and differential diagnosis, treatment and prognosis of lymphoma papulosis for improving the cognition on this disease. Methods The clinical, histopathological and immunofluorescence data in one case of the lymphoma papulosis were analyzed and the relevant literature was analyzed. Results The Patient with lymphoma papulosis showed erythema, papules, blisters, scabs with itch happened repeatedly in entire body over one month. Dermatologist check: visible diffuse distribution of erythema, papules, and blisters, all of which had the size of rice to the size of soybean, on the trunk and limbs; partial skin had necrosis, and scabs. The ulcer, which had the size of soybean to the size of coin, could be seen on the scrotum and penis skin. The whole body had no obvious pustules, and each joint and toenail had no obvious abnormity. Skin tissue pathological examination: degeneration and necrosis of epidermis, formation of subepidermal blisters, intradermal hemangiectasis, fibrinoid degeneration of vascular wall, obvious inflammatory cell infiltration around the blood vessels, and obvious abnormity cells and nuclear mitosis could be seen. Immunofluorescence examination: IgG (-), IgM (-), IgA (-), C3 (-). The acid fast stain was negative. Immunohistochemical examination: intradermal infiltrating cells expressed CD3 (+), CD4 (-), CD8 (+), CD20 (-), CD30 (+), CD56 (-), and Ki67 (+>50%). T lymphoma cloned gene rearrangement (+). Diagnosis: C lymphoma papulosis. Conclusion The lymphomatoid papulosis (LyP) is an inert cutaneous lymphoma that features chronic relapsing, self-healing skin papules, necrosis, nodules, and clinical benign while appearing malignance in histopathology; and it belongs to skin CD30 (+) lymphoproliferative disease. Its exact pathogenesis is not yet clear. The treatment can only alleviate the symptoms, but cannot prevent the relapse of the disease. At present, there is no effective treatment in preventing the secondary lymphoma, and long-term follow-up monitoring and treatment of the secondary lymphoma are needed.