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Objective To analyze the clinical and histopathological features,immunophenotypes,treatment and prognosis of subcutaneous panniculitis-like T cell lymphoma (SPTL).Methods Clinical and experimental data were collected from 9 cases of SPTL,and retrospectively analyzed.Related pathological and immunohistochemical markers were examined by Envision method.Eight patients were followed up.Results Of the 9 patients,8 had multiple subcutaneous nodules and plaques,which mainly involved the lower limbs in 8 patients and the trunk in 6 patients.Seven patients had fever.Three patients were subjected to the whole-body positron emission tomography-computed tomography (PET-CT),and 7 to bone marrow aspiration.No visceral tumors and hemophagocytic syndrome were found.Histopathological examination of skin lesions showed atypical mononuclear cells with large nuclei and deep staining,which mainly infiltrated the subcutaneous adipose tissue and were arranged in a circular pattern.Among 9 patients,infiltration of tumor cells was observed around skin appendages and blood vessels in the dermis in 5 patients.Immunohistochemical examination showed positive staining for βF1,CD3 and CD8 in tumor cells in 9 cases,positive staining for granzyme B and T-cell-restricted intracellular antigen-1 (TIA-1) in 8 cases,and negative staining for CD4,CD20,CD30 and CD56 in all the patients.Five patients received chemotherapy,including a child and a postpartum woman.One child received methylprednisoloue pulse therapy.During the follow-up,8 patients achieved a complete clinical remission after treatment.Conclusion SPTL is derived from α/β T cells,and histopathological and immunohistochemical examinations can be helpful for its diagnosis and differential diagnosis.
RESUMEN
Small scale restricted online course (SPOCs)+flipped classroomteaching is expected to become an important complement to the traditional teaching of dermatology. In this teaching mode, first of all knowledge nodes are divided separately according to the syllabus and for each node, 7 to 10 minutes of micro video or micro-lecture is made, which enables students to make best use of fragmented time through the network to master relevant knowledge independently before the trainee. In the flipped classroom, based on the difficulties and misunderstandings of learning reflected from the network monitor data, teacher can make full use of time on demonstrating typical cases, organizing discussion, grouping students to take diag-nostic and therapeutic exercise, answering targeted questions, teaching clinical thinking, experience and doctor-patient communication skills. Through this teaching mode, the new teaching idea can be imple-mented that students are in dominant position while teachers are in leading position, which contributes to deepening the understanding , absorption and application of knowledge and improving students' ability of communication, cooperation, diagnosis and treatment.