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style=\"font-size: 15px;\">皮肤T细胞淋巴瘤（cutaneous T-cell lymphoma, CTCL）属于结外非霍奇金淋巴瘤（Non-Hodgkin’s lymphoma，NHL）中的一种，起源于称为T淋巴细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">皮肤T细胞淋巴瘤包含多种不同的疾病，其中蕈样霉菌病（mycosis fungoides，MF）和Sézary综合征（sézary syndrome，SS）是最常见的类型；MF占CTCL的50%，而SS占CTCL的5%； 大多数患者是中老年人群，男性多于女性。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">与其他部位的淋巴瘤相比，皮肤淋巴瘤的症状容易被发现，且能及时进行活检；蕈样霉菌病常表现为惰性淋巴瘤，早期疾病预后良好；而 Sezary 综合征被认为是一种侵袭性更强的疾病，导致患者生存期缩短。\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-08-03",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"cause","病因","\u003Cdiv>\u003Cspan style=\"font-size: 15px;\"> 皮肤T细胞淋巴瘤的发病机制尚不清楚。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">一般来说，当细胞的 DNA 发生变化（突变）时，细胞的分裂和增殖出现问题，产生了许多异常的细胞，肿瘤就发生了。在皮肤T细胞淋巴瘤中，细胞DNA突变会导致过多的异常T细胞攻击皮肤，但产生这一现象的原因暂未阐明。\u003C\u002Fspan>\u003C\u002Fdiv>","🧬",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"symptom","症状表现","\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">皮肤 T 细胞淋巴瘤的症状取决于肿瘤扩散的程度（阶段），很多症状可能和其他皮肤病相似，如果出现异常症状请及时就医寻求帮助。皮肤 T 细胞淋巴瘤的体征和症状包括：\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·出现凸起或干燥、红色、鳞片状的圆形皮肤斑块，患者可能会感觉发痒；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·出现比周围皮肤颜色更浅的皮肤斑块；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·皮肤上出现肿块，该肿块有可能会破裂；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·淋巴结肿大；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·脱发；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·手掌和脚底的皮肤增厚；\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">·全身任何部位都可能出现皮疹，患者会感觉非常痒。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">蕈样霉菌病的病变特征为出现皮肤上的红斑、斑块或肿瘤结节；结节常常溃烂并导致继发感染；以上症状可发生在患者的全身皮肤，常伴皮肤瘙痒。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">在Sézary综合征中，患者可出现皮肤红肿，伴手掌和脚掌开裂；淋巴结肿大通常为轻度至中度；患者的症状多与皮肤病变相关，后期可能会出现发热、盗汗、及原因不明的体重减轻。\u003C\u002Fspan>\u003C\u002Fdiv>","📋",{"key":100,"title":101,"html":102,"updatedAt":88},"exam","检查方式","\u003Cdiv>当怀疑患者为皮肤T细胞淋巴瘤时，医生首先会做全面的体格检查，然后需要对患者进行组织活检、实验室检查、影像学检查、细胞遗传学和分子生物学检测来确诊。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>1.体格检查\u003C\u002Fdiv>\u003Cdiv>体格检查包括测量生命体征、检查患者的皮肤、触诊全身浅表淋巴结等。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>2.组织活检\u003C\u002Fdiv>\u003Cdiv>所有患者都需要通过皮肤活检、淋巴结活检或骨髓穿刺来确诊以及确定疾病的阶段。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>·皮肤活检：用于诊断或帮助治疗皮肤疾病，医生会在局部麻醉的情况下取一小块皮肤组织（肿瘤组织），在实验室中检查组织是否有肿瘤细胞。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>·淋巴结活检：一般医生需要完整切除或切取可疑淋巴结进行活检，如果无法切除或切取样本，也可穿刺活检。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>·骨髓穿刺：医生可能会同时进行两个部位的骨穿，对所抽取骨髓样本进行涂片、免疫分型、染色体、基因等检查，也可进行骨髓活检。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>3.血液检查\u003C\u002Fdiv>\u003Cdiv>除了血常规，还需要做外周血涂片看血液中是否出现了恶性的T淋巴细胞，如Sézary细胞。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>4.影像学检查\u003C\u002Fdiv>\u003Cdiv>做胸部、腹部和盆腔CT或PET\u002FCT来看淋巴瘤是否累及了其他器官。\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cdiv>内容来源：\u003C\u002Fdiv>\u003Cdiv>中国淋巴瘤治疗指南（2021年版）\u003C\u002Fdiv>\u003Cdiv>Mayo Clinic\u003Cbr\u002F>\u003C\u002Fdiv>",{"key":104,"title":105,"html":106,"icon":107,"updatedAt":88},"treatment","治疗方式","\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">皮肤T细胞淋巴瘤患者适合哪种治疗取决于患者的具体情况，如淋巴瘤的类型、分期等，多数患者需要接受联合治疗。皮肤T细胞淋巴瘤常用的治疗方法包括药物、放疗、化疗、光疗、体外光分离术和造血干细胞移植等。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">1.药物治疗\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">·外用药\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">患者可以使用乳膏、凝胶和软膏形式的药物，涂抹在皮肤上，常用的药物有皮质类固醇和化疗药物；皮质类固醇类药物可以帮助患者缓解皮肤发红和发痒的症状；外用的化疗药物可以直接应用在皮肤，攻击肿瘤细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">·口服或静脉注射药\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">如化疗药、靶向治疗药物和免疫疗法等。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">2.光动力疗法（光疗）\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">光疗是把患病皮肤暴露在特定波长的光下，目的是杀死癌细胞，但治疗过程中正常的皮肤细胞也会被波及，但治疗后健康的皮肤细胞会快速再生，而肿瘤细胞不会；治疗时患者要进入一个隔间，把皮肤暴露出来，然后由机器发射出特定波长的光对其进行照射；有时患者需要服用让皮肤细胞对光更敏感的药物后，再进行光疗。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">3.放射治疗（放疗）\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">放疗使用 X 射线杀死癌细胞并缩小肿瘤，如果患者的皮肤T细胞淋巴瘤处于局限期，可以使用局部放疗；如果患者已经出现了广泛的皮肤病变，可以选择全皮肤电子束疗法（TSEBT）治疗。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">4.体外光分离置换疗法\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">体外光分离置换疗法可以杀死血液中的淋巴瘤细胞，患者的血液要通过一台暴露在特殊紫外线光下的机器，然后再将血液输回，这个过程中机器发射的紫外线光可以杀死淋巴瘤细胞。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>\u003Cp>\u003Cspan style=\"font-size: 15px;\">5.造血干细胞移植\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cspan style=\"font-size: 15px;\">\u003Cbr\u002F>\u003C\u002Fspan>\u003C\u002Fp>\u003Cdiv>\u003Cspan style=\"font-size: 15px;\">造血干细胞移植是用来自供者的健康干细胞替换患者的干细胞，移植期间，患者将接受大剂量的放、化疗来抑制患病的骨髓，然后将健康的供体细胞注入身体，重建患者的骨髓生态。\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">对于病情难以控制的患者，可考虑做异基因造血干细胞移植。\u003C\u002Fspan>\u003C\u002Fdiv>\u003Cdiv>\u003Cbr\u002F>\u003C\u002Fdiv>","💊",{"author":109,"reviewedBy":109,"lastReviewed":109,"datePublished":109,"citations":110,"disclaimer":109},"",[111,113,115],{"title":112},"中国淋巴瘤治疗指南（2021年版）",{"title":114},"Mayo Clinic",{"title":116},"默沙东诊疗手册",false,1789384106621]