皮肤淋巴细胞浸润症

报告1例皮肤淋巴细胞浸润症.患者女,41岁.因左鼻翼皮肤红色斑疹半年来我院门诊就诊,既往曾多次被诊断为"毛囊炎"、"痤疮"等,但治疗效果欠佳.皮损组织病理检查:真皮中、深层血管及皮肤附属器周围可见以淋巴细胞为主的带状浸润.免疫组化染色:CD68(+)、CD3(+++)、CD45RO(+++)、CD20(+)及CD79a(-).根据临床表现及组织病理检查结果,诊断为皮肤淋巴细胞浸润症.     

皮肤淋巴细胞浸润症1例

报告1例皮肤淋巴细胞浸润症。患者男，32岁。面部出现红色斑块2年，胸部、背部、四肢出现类似皮损1年。组织病理示皮肤淋巴细胞浸润症。经氯喹等药物治疗，皮损好转。目前仍在随访中。     

带状疱疹后皮肤淋巴细胞浸润1例

报告1例带状疱疹后皮肤淋巴细胞浸润，患者男，54岁，疱疹痊愈后2个月须皮损部位出现多个斑丘疹和丘疹，组织病理检查示真皮浅，中层以T淋巴细胞为主的浸润，诊断为带状疱疹继发皮肤淋巴细胞浸润，治疗3个月后皮损全部消失。     

皮肤淋巴细胞浸润症1例

患者女,57岁。右鼻背处皮疹2年余。结合临床特点、病理及免疫病理诊断皮肤淋巴细胞浸润症明确,给予以小剂量激素联合羟基氯喹、雷公藤多甙片、氨苯砜口服并联合外用制剂治疗,取得满意疗效。     

皮肤淋巴细胞浸润症1例

患者女，48岁。半年前无明显诱因于双手背出现紫红色丘疹，且逐渐增大，呈紫红色浸润性斑块，皮损无瘙痒。患者曾在外院按“扁平苔藓”诊治，予口服抗组胺药、外用糖皮质激素等治疗，局部皮损未见明显好转，遂于2003年12月27日来我所就诊。患 者起病以来，一般情况好，未出现发热等症状，家族中无类似疾病史。     

皮肤淋巴细胞浸润症1例

患者男,60岁,左股内侧斑块1年余增大伴破溃1个月。体检:左股内侧有一4 cm×8 cm红色浸润性斑块,质中,界清,中心破溃后形成直径1 cm,深约0.8 cm大小的溃疡。组织病理:真皮全层以淋巴样细胞为主的混合性炎细胞浸润。淋巴细胞核异型性明显,免疫组化:CD3(+),CD20(+),CD30(+),CD56(-)。确诊。     

皮肤淋巴细胞浸润症

目的:探讨皮肤淋巴细胞浸润症(lymphocytic infiltration of skin,LIS)的病因、临床与组织病理特点、诊断与鉴别诊断、治疗与预后.方法:报告1例少见的LIS,并复习国内外相关文献.结果:典型皮损表现为紫红色或黄红色浸润性斑块,好发于面部;组织病理检查可见大量淋巴细胞团块状浸润,表皮无异常改变.病程经过良性,常可自发性缓解和复发.LIS需与盘状红斑狼疮、多形日光疹、网状红斑黏蛋白病、假性淋巴瘤鉴别,但鉴别困难.治疗方法有多种,但不能预防复发.结论:LIS皮损主要累及头、面、颈部等曝光部位,组织病理学表现以T淋巴细胞浸润为主,用595 nm脉冲染料激光对LIS治疗有良好的效果,并且无不良反应,但是否复发,须进一步观察.     

皮肤淋巴细胞浸润症1例

患者男,50岁,右侧颞部、肩北部起皮疹,伴瘙痒半年余,于2004年4月15日来我科就诊。患者2003年8月无明显诱因右侧颞部、肩北部先后出现数个米粒大紫红色扁平皮疹,未予治疗,皮疹逐渐增多,并隆起增大,部分相互融合成紫红色斑块,有轻度瘙痒,无光敏,既往无外伤及手术史。     

淋巴细胞受体基因重排分析在皮肤淋巴细胞浸润疾病中的应用…

综述了淋巴细胞受体的生物学特点，基因重排常用的检测方法以及基因重排分析在皮肤淋巴细胞浸润疾病中的应用，强调指出用分子生物学技术检测皮肤淋巴细胞浸润疾病中淋巴细胞受体基因重排在确定其细胞源性，克隆性及其诊断，分期，监测治疗反应等方面具有重要价值。     

皮肤淋巴细胞浸润症研究进展

皮肤淋巴细胞浸润症(LIS)又称Jessner-Kanof综合征,是一种慢性、良性淋巴细胞浸润性疾病,病程中可有自发性缓解倾向,但可复发.该病较少见,好发于成人,儿童也可累及,其病因及发病机制目前尚未明确.本文就LIS的临床研究进展综述如下.     

A case of acral lentginous melanoma: the correlation between CD95L expression on melanoma cells and apoptosis of tumor infiltrating lymphocytes

There is an increasing amount of evidence that melanoma cells express the ligand for CD95 (CD95L), a potent inducer of apoptosis which contributes to creating the immune privileged circumstances of tumor sites. However, it still remains to be demonstrated whether the capacity of melanoma cells to express CD95L is acquired during the progression. We addressed this question with a case of acral lentiginous melanoma by employing immunostaining using an antibody directed against CD95L as well as by in situ TUNEL staining. H&E-staining of tumor specimens revealed that there were two different growth patterns. The central part of the tumor showed a deeper invasion into the dermis (Breslow thickness >4 -mm). The horizontally growing edge of the tumor proliferated more superficially (Breslow thickness<3-mm). Relatively fewer lymphocytes were observed around the melanoma nests in central areas, which expressed detectable amounts of CD95L. In contrast, more lymphocytes were observed among the melanoma cells in the peripheral lesion, where CD95L was not detected. To evaluate the relevance of the CD95L expression, in situ TUNEL staining was performed. This indicated a significant correlation of lymphocyte apoptosis with CD95L expression on melanoma cells. Together the data suggest that expression of CD95L is turned on depending on the level of melanoma, and that it may tribute to creating immune privileged circumstances by initiating apoptosis of tumor filrating lymphocytes.     

Prognostic value of tumor-infiltrating Foxp3+ T-cell subpopulations in metastatic melanoma

Regulatory T cells have already been associated with poor prognosis in various types of cancer. It was previously reported, in ovarian carcinoma, that quantification of Foxp3 identified a subgroup of patients characterized by a significantly worse prognosis in terms of overall survival (OS) and progression-free survival (PFS), suggesting that high expression levels of Foxp3 might represent a surrogate marker for an immunosuppressive microenvironment contributing to tumor immune escape. The main objective of the present study was to precise the prognostic value of Foxp3 regarding PFS and OS in stage III (AJCC) melanoma patients. Total RNA was isolated from 102 metastatic melanoma lymph nodes and from eight tumor-free lymph nodes. Real-time PCR for Foxp3 was performed and correlated with patients' outcome. Quantification of Foxp3 identified a patient subgroup (>90th percentile), which is characterized by a significantly worse prognosis in terms of PFS (P = 0.000271) but not in terms of OS (P = 0.11). In conclusion, quantification of Foxp3 expression using qPCR appears as an independent prognostic factor for PFS in stage III melanoma patients (AJCC). High Foxp3 expression might thus enable the identification of patients most at risk of relapse.     

Vaccination of Japanese patients with advanced melanoma with peptide, tumor lysate or both peptide and tumor lysate-pulsed mature, monocyte-derived dendritic cells

We performed a clinical trial to assess the feasibility and efficacy of immunotherapy with peptides, tumor lysate or both peptides and tumor lysate-pulsed mature, monocyte-derived dendritic cells (DC) for advanced malignant melanoma patients that are resistant to conventional therapies. Sixteen patients were enrolled in this trial. All patients received DC vaccines i.d. in the proximal thigh, close to the inguinal lymph nodes, one treatment per week or 2 weeks. Several factors such as clinical findings, computed tomography (CT) images, delayed type hypersensitivity (DTH) response, enzyme-linked immunosorbent spot (ELISPOT) assay, and immunohistochemistry in primary, metastatic lesions and the DTH site were evaluated. Clinical results through DC vaccination were as follows: in 11 evaluable cases, three stable disease, six progression of disease and two disease-free from the time of study entry to the completion of one vaccination course. One patient showed reduction of the tumors in the metastases on chest CT during the first and second course of DC vaccination. Ten out of 14 evaluable cases showed positive DTH responses to more than one treatment with melanoma peptides or tumor lysate. Eight out of 13 evaluable cases showed positive immunological responses to more than one treatment with melanoma peptides or tumor lysate in an ELISPOT assay. As for the experiences with toxicity and adverse reactions, autosensitization dermatitis-like eruptions appeared in five cases during DC vaccination. No severe adverse effects were seen in any of the patients. In our study, the clinical efficacy in prolongation of the patients' survival was confirmed. At the same time, cancer immunoediting of the tumor was also found. It will be necessary to improve the tumor-specificity of this therapeutic approach and to analyze the mechanism(s) of tumor escape from immunosurveillance in melanoma.     

Case of tumor thrombus inside femoral vein,formed by melanoma metastasized to inguinal lymph node

Inguinal lymph nodes are often excised in dermatological surgery, because they are the most common of the lymphatic basin involved in metastasis of malignant skin tumor on the lower extremities or genital region. Herein, we describe a case of cutaneous malignant melanoma on the buttock of a 78‐year‐old woman. Under the huge metastasized inguinal lymph node, there was tumor invasion into the femoral vein with intraluminal tumor thrombus formation. Careful preoperative radiological assessment enabled successful resection on surgery. A review of the published work revealed that tumor thrombus due to direct invasion of melanoma may be rare. The possibility of intravenous tumor thrombus should be considered in the settings of surgery of inguinal metastasis of melanoma, especially when a large‐sized node is located near the great veins.     

Serum levels of leptin receptor in patients with malignant melanoma as a new tumor marker

Leptin is known to be abnormally expressed in a variety of cancers, and leptin receptors have been reported to be expressed on human melanoma cells. In this study, we evaluated the possibility that the serum levels of leptin receptor could be a tumor marker of malignant melanoma (MM). Serum samples were obtained from 71 patients with MM, and the serum levels of leptin receptor were measured by double‐determinant ELISA. Interestingly, serum levels of leptin receptor decreased gradually with the stages of MM, being highest at in situ and lowest at stage IV. There was also a trend of reverse correlation between tumor thickness and serum levels of leptin receptor. To our knowledge, this is the first report investigating the serum levels of leptin receptor in MM, and serum leptin receptor levels may be used as a useful tumor marker of MM.     

基质金属蛋白酶7在恶性黑素瘤中的表达

目的 探讨基质金属蛋白酶7（MMP7）的表达与恶性黑素瘤浸润、转移的关系。方法 采用免疫组化SP法研究MMP7在恶性黑素瘤（30例）、交界痣（30例）、正常人皮肤（15例）组织中的表达，并观察其在恶性黑素瘤A375细胞株和不同浓度乙酰肝素酶反义寡核苷酸转染的裸鼠体内恶性黑素瘤移植瘤中的表达情况。结果 MMP7在恶性黑素瘤组、交界痣组及正常人皮肤组中的阳性表达率分别为83.33%（25/30）、6.67%（2/30）和0，恶性黑素瘤组与交界痣组MMP7的阳性表达率比较，χ2 = 35.62，P < 0.01；交界痣组与正常人皮肤组比较，差异无统计学意义。10、20、30 μmol/L乙酰肝素酶反义寡核苷酸对裸鼠体内恶性黑素瘤移植瘤MMP7表达表现出不同程度的抑制作用，30 μmol/L组的抑制作用最强，与其他2个组相比，差异均有统计学意义（P < 0.05）。MMP7在A375细胞株中呈强阳性表达。结论 MMP7在恶性黑素瘤中的表达明显高于其在交界痣和正常人皮肤；乙酰肝素酶反义寡核苷酸对裸鼠体内恶性黑素瘤移植瘤中MMP7的表达有显著抑制效应；MMP7在A375细胞株中呈强阳性表达。     

Tumour-infiltrating lymphocytes and melanoma tumorigenesis: an insight

The presence of tumour-infiltrating lymphocytes (TILs) amid the tumour cells in the stroma and overlying epidermis is a constant feature of melanoma, the deadliest skin cancer. These lymphocytes are mostly cytotoxic T cells (CTLs) that can be propagated in vitro by specific cytokines. Also, they can kill melanoma cells. This specific killing can be abrogated by monoclonal antibodies against CD3, CD8, T-cell receptors (TCRs) and against class I human leucocyte antigens (HLAs). This indicates that these CTLs can recognize the melanoma cells through the TCRs, in an HLA class I-restricted manner. Therefore, these cells and their products both are critical players in T cell-induced melanoma regression and are powerful predictors of survival. This review seeks to examine the characteristics, activation and role of TILs and their associated molecules in melanomas.     

FAS,FAS ligand,tumor infiltrating lymphocytes,and macrophages in malignant melanoma: an immunohistochemical study

Background FAS and its ligand, FASL, have important roles in the neoplasia‐immunity relationship. In melanoma, the importance of FAS and FASL remains controversial, despite a group of studies. In this study, we aimed to demonstrate the distribution of FAS/FASL in melanotic lesions and to investigate the correlation between tumor infiltrating lymphocytes and macrophages. Methods Ten intra‐dermal nevi, 12 primary malignant melanoma, and eight skin and 15 lymph node metastases were included in this study. FAS and FASL were studied in all of the groups using classical labeled streptavidin‐biotin immunohistochemical method. Tumor infiltrating lymphocyte status and macrophage number demonstrated by CD68 immunostain were also evaluated in primary melanoma and skin metastases. Results FAS positivity was detected in all of the cases. FASL expressions were seen in 60% of the intra‐dermal nevus and in all of the other groups. There were significant differences in FASL between nevus and primary melanoma, nevus and skin metastasis, and nevus and lymph node metastasis. There were strong positive correlations between FAS expression and intra‐neoplastic macrophage score and between FASL and density of lymphocyte infiltration in skin metastases. Conclusion Although FAS and FASL expression is a constant feature of melanotic lesions, its diagnostic importance is very limited because of the different results obtained in the past studies. The correlation between FAS status and macrophage number and between FASL status and lymphocyte number in skin metastasis but not in primary lesions might point to diverse FAS/FASL interaction between neoplastic cells and macrophages in the different microenvironments.     

Analysis of APAF-1 expression in human cutaneous melanoma progression

APAF-1 plays a pivotal role in mitochondria-dependent apoptosis, binding to cytochrome c and favoring activation of caspase-9. It has been shown that epigenetic silencing of the APAF-1 gene is a common event in several metastatic melanoma cells in vitro. We determined, by Western blot, variation in the level of expression of APAF-1 in several human melanoma cell lines and, by immunohistochemistry, in a group of 106 histological samples including benign and malignant melanocytic lesions. We observed APAF-1 down-regulation or loss of expression in two metastatic melanoma cell lines, compared to primary melanoma cell lines. The immunohistochemical analysis revealed a significant difference in APAF-1 staining between nevi and melanomas. In addition, we found a significant negative correlation between APAF-1 expression level and tumor thickness and between primary melanomas and metastases. We conclude that loss of APAF-1 expression can be considered as an indicator of malignant transformation in melanoma.