위눈꺼풀에 발생한 원발성 기타 상세불명의 말초 T세포 림프종 1예
A Case of Primary Eyelid Peripheral T-Cell Lymphoma, Not Otherwise Specified
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목적: 눈꺼풀에 원발성으로 발생한 기타 상세불명의 말초 T세포 림프종을 경험하였기에 보고하고자 한다. 대상과 방법: 고혈압 외에 특이 과거력 없는 48세 남자가 두 달간의 우측 위눈꺼풀 종괴를 주소로 내원하였다. 종괴는 우안 위눈꺼풀가쪽에 위치하였고, 경계가 분명한 타원형의 붉은 빛을 띠는 약 8×4 mm 크기의 피하 종괴였다. 절개배농 및 트리암시놀론 국소 주사하였으나, 호전되지 않아 진단을 위한 국소마취하 절제생검을 시행하였다. 결과: 절제된 종괴는 조직학적 검사상 상피 아래에 국소적으로 치밀한 림프구의 침윤이 보였고, 고배율에서 세포학적 비정형을 보였다. 면역조직화학검사상 CD3 양성이었고 CD20, CD30, CD56, ĸ-light chain 면역 글로불린, λ-light chain 면역 글로불린 음성이며Ki-67의 증가가 관찰되어 기타 상세불명의 말초 T세포 림프종으로 확진되었다. 결론: 기타 상세불명의 말초 T세포 림프종에서는 전신 림프절종대, B 증상과 같은 전신증상이 흔하게 나타나며, 눈꺼풀에서 발생하는경우는 매우 드물다. 저자들은 특이 과거력 없이 건강한 사람에게 전신증상 없이 눈꺼풀에 빠르게 자라는 원발성 종괴의 형태로 생기는 드문 경우를 경험하였기에 보고하고자 한다.
Abstract
Purpose: To report a case of primary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), of the eyelid. Methods: A 48-year-old healthy male patient presented with a mass on the upper lid of 2 months in duration. The lesion was reddish, well - demarcated, oval shaped, and measured approximately 8 × 4 mm. The mass did not respond to incisional drainage and intra-lesional triamcinolone. An excisional biopsy for diagnosis was performed. Results: On microscopic examination, a localized dense lymphocytic infiltration was observed in the subepithelial area,and cytologic atypia was observed under high power. On immunohistochemical examination, tumor cells were positive for CD3 but negative for CD20, CD30, CD56, ĸ-light chain immunoglobulin, λ-light chain immunoglobulin, and increased Ki-67activity was noted. A histopathological diagnosis of PTCL-NOS was made. Conclusions: PTCL-NOS, which rarely occurs on the eyelids, commonly accompanies generalized lymphadenopathy and “B symptoms” such as fever and weight loss. Herein, the authors report a case of PTCL-NOS of the eyelid presenting as a rapidly growing solid mass in an otherwise healthy patient.
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