Linfoma cutáneo angiocéntrico de células T que semeja hidroa vacciniforme
2005
Introduccion. Los linfomas cutaneos son procesos linfoproliferativos malignos de celulas B o T, con una variedad de manifestaciones clinicas, sin que exista enfermedad extracutanea al momento del diagnostico. Existen reportes de casos de lesiones cutaneas previas, determinadas por fotosensibilidad, que se asocian a linfomas cutaneos. Se presenta el caso de un paciente femenino con diagnostico de linfoma cutaneo angiocentrico que semeja hidroa vacciniforme. Caso clinico. Adolescente femenino de 14 anos de edad, que ingreso al Hospital General Dr. Aurelio Valdivieso del Estado de Oaxaca en el mes de octubre de 2003. Cuadro actual: 8 meses previos a su ingreso con dermatosis en areas expuestas al sol, caracterizadas por vesiculas y papulas, que evolucionaron a ulceras y necrosis en miembros toracicos y piernas, con hepatoesplenomegalia y edema centrofacial. La histopatologia de la lesion revelo vasculitis angiocentrica, angiodestructiva, con linfocitos atipicos y paniculitis. Se definio el diagnostico de linfoma cutaneo angiocentrico. Se instalo quimioterapia combinada con involucion de su dermatosis y compromiso sistemico. Conclusion. El presente caso cumple con criterios clinico e histopatologicos de linfoma cutaneo angiocentrico, con adecuada respuesta a quimioterapia de combinacion, sobre todo basada en antraciclinas.(AU) Introduction. The cutaneous lymphoma is a malignant lymphoproliferative process of B or T, cells with a variety of clinical manifestation without extracutaneous disease at the time of diagnosis. There are case reports in the literature which have associated prior cutaneous injuries, with cutaneous lymphoma as determined by photosensitization. The present case report is of a female patient with diagnosis of cutaneous angiocentric lymphoma which resembled hydroa vacciniform. Case report. Female adolescent 14 year of age who was admitted to Hospital General Dr. Aurelio Valdivieso in the State of Oaxaca, Mexico. Eight months prior to hospital admission she presented dermatosis in areas exposed to the sun, characterized by vesicles, papules which evolved to ulcers and necrosis in arms and legs, she also presented with hepatosplenomegaly and facial edema. The histopatology of the lesions revealed angiodestructive, angiocentric vasculitis with atypical lymphocytes and paniculitis. The diagnosis of angiocentric cutaneous lymphoma was made. The patient was treated with combined chemotherapy with involution of her dermatosis and systemic findings. Conclusion. The present case fulfills the histopathology and clinical criteria of an angiocentric cutaneous lymphoma, with suitable response to combined chemotherapy based on anthracyclines.(AU)
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