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Phlebologie 2005; 34(03): 171-175
DOI: 10.1055/s-0037-1621477
Originalarbeit
Schattauer GmbH

Intravaskuläres Lymphom unter dem klinischen Bild einer therapieresistenten Thrombophlebitis

Extranodal cutaneous lymphoma presenting as therapy resistant thrombophlebitisLymphome cellulite-T intraveineux se presentant comme d’une thrombophlébite résistante aux traitements
H. Griefingholt
1   Institut für Pathologie, Bonn-Duisdorf
,
E. Meyer zu Vilsendorf
2   Chirurgisch-Phlebologische Praxisgemeinschaft, Bünde
,
U. Bosse
3   Institut für Pathologie, Osnabrück
,
T. Mentzel
4   Dermatopathologische Gemeinschaftspraxis, Friedrichshafen
› Author Affiliations
Further Information

Publication History

Publication Date:
30 December 2017 (online)

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Zusammenfassung

Wir berichten über eine 63-jährige Patientin, die nach einmonatiger erfolgloser antibiotischer Therapie aufgrund eines Erysipels rechts mit der Verdachtsdiagnose einer therapieresistenten Thrombophlebitis in einer phlebologischen Praxis vorgestellt wurde. Klinisch imponierte ein derbes rotes, schmerzhaftes und brennendes Areal im Bereich der rechten Wade sowie mehrere bis 3 cm große derbe, leicht druckschmerzhafte Areale des linken Beines mit Betonung des Unterschenkels. Hinweise für eine tiefe Beinvenenthrombose oder eine Thrombophlebitis fanden sich nicht. Histologie: In der konventionellen histologischen Untersuchung fand sich zunächst das Bild eines hochmalignen, intravaskulären Tumorgeschehens. Mit Hilfe immunhistochemischer Färbungen wurde ein intravaskuläres (angiotropes) T-Zell-Lymphom (maligne Angioendotheliomatose) gesichert. Schlussfolgerung: Der Fall unterstreicht die Notwendigkeit der frühzeitigen histologischen Untersuchung auch vermeintlich harmloser Hautveränderungen.

Summary

A 63-year old woman went to a phlebologist with suspected therapy-resistant thrombophlebitis following ineffective antibiotic treatment for erysipelas during the previous month. Clinically there was a large solid painful and burning reddish area at the right leg and some smaller solid painful areas at the left leg up to 3 cm in diameter. Signs of deep thrombosis or thombophlebitis were missing. Histopathology: Conventional histology showed a highly malignant, mainly intravascular neoplasm. Immunohistochemical staining confirmed an intravascular large T-cell lymphoma. Conclusion: This case underlines the need of early histological examination of supposed harmless changes of the skin.

Résumé

On fait le rapport d‘une patiente de 63 ans, qui se présentait chez un phlébologue avec les symptomes d‘une thrombophlébite après un traitemant antibiotique infructueux durant un mois car on suspectait d‘abord un érysipèle. Cliniquement se présentait une vaste zone rougie, douloureuse et brulante au niveau de la cheville droite ainsi que quelques unes plus petites de la pied que atteignait trois centimètres en diamètre. Il manquait tout signes de thrombose ou de thrombophlébite profonde. L‘examen histologique conventionnel montrait une tumeur de haut grade de malignité au niveu des vaisseaux sanguins, mais après la coloration histochimique, se dévoilait un lymphome cellule- T intraveneux (angioendothéliomatose maligne). Conclusion: Ce cas souligne la nécessité d’ examens histologiques à temps de lésions cutanées sans gravité prétendue.

Schlüsselwörter

Therapieresistente Thrombophlebitis - intravaskuläres T-Zell-Lymphom

Keywords

Therapy resistant thrombophlebitis - intravascular large T-cell lymphoma - malignant angioendotheliomatosis

Mots clés

Therapy resistant thrombophlebitis - intravascular large T-cell lymphoma - malignant angioendotheliomatosis
 

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