¤ł¤ł ¤Ť¤é ˝ü¤¤ ĽŃĽÁĽóĽł


”畆ˆŤŤŽîá‡

 

ⅠDŒ´”­Ť”畆ƒŠƒ“ƒpŽî‚Ě•aŒ^‚Ć•aŠú•Ş—Ţ

‚PDŒ´”­Ť”畆ƒŠƒ“ƒpŽî‚Ě•aŒ^

Œ´”­Ť”畆ƒŠƒ“ƒpŽî‚Ě•aŒ^

”畆T ×–EENK ×–EƒŠƒ“ƒpŽî

‹Űó‘§“÷ÇiMycosis fungoides: MFj
‹Űó‘§“÷Ç‚ĚƒoƒŠƒAƒ“ƒg‚ĆˆŸŒ^

–Ń•ďŒüŤ‹Űó‘§“÷ÇiFolliculotropic MFj
ƒpƒWƒFƒbƒg—l×–ԏǁiPagetoid reticulosisj
“÷‰čŽî—l’oŠÉ”畆iGranulomatous slack skinj

Sézary ÇŒóŒQ
ŹlT ×–E”’ŒŒ•aEƒŠƒ“ƒpŽîiAdult T-cell leukemia/lymphomaj
Œ´”­Ť”畆CD30 —zŤƒŠƒ“ƒp‘BÇiPrimary cutaneous CD30 { T-cell lymphoproliferative disordersj

  • Œ´”­Ť”畆–˘•Ş‰ť‘ĺ×–EƒŠƒ“ƒpŽîiPrimary cutaneous anaplastic large cell lymphomaj
  • ƒŠƒ“ƒpŽî—l‹u]ÇiLymphomatoid papulosisj

”牺Ž‰–bD‰Š—lT ×–EƒŠƒ“ƒpŽîiSubcutaneous panniculitis-like T-cell lymphomaj
ßŠOŤNK/T ×–EƒŠƒ“ƒpŽîC•@Œ^iExtranodal NK/T-cell lymphoma, nasal typej
Ží“——l…ávÇ—lƒŠƒ“ƒpŽî@iHydroa vacciniforme-like lymphomaj
Œ´”­Ť”畆ƒÁƒÂT ×–EƒŠƒ“ƒpŽîiPrimary cutaneous ƒÁƒÂT-cell lymphomaj
Œ´”­Ť”畆CD8 —zŤisŤ•\”çŒüŤ×–EŠQŤT ×–EƒŠƒ“ƒpŽî
 iPrimary cutaneous CD8 { aggressive epidermotropic cytotoxic T-cell lymphomaj*
Œ´”­Ť”畆CD4 —zŤŹE’†×–EŒ^T ×–EƒŠƒ“ƒpŽîiPrimary cutaneous CD4 { small/medium T-cell lymphomaj*
––˝ŤT ×–EƒŠƒ“ƒpŽîC”ń“ÁˆŮiPeripheral T-cell lymphoma, NOSj

”畆B ×–EƒŠƒ“ƒpŽî

”S–ŒŠÖ˜AƒŠƒ“ƒp‘gD‚̐ߊOŤ•Ó‰‘ŃƒŠƒ“ƒpŽîiMALT ƒŠƒ“ƒpŽîj
 iExtranodal marginal zone lymphoma of mucosa-associated lymphoid tissuej
Œ´”­Ť”畆ŕh–E’†SƒŠƒ“ƒpŽîiPrimary cutaneous follicle center lymphomaj
Œ´”­Ť”畆‚Ń‚Ü‚ńŤ‘ĺ×–EŒ^B ×–EƒŠƒ“ƒpŽîC‰şŽˆŒ^#iPrimary cutaneous diffuse large B-cell lymphoma, leg typej
ŒŒŠÇ“ŕ‘ĺ×–EŒ^B ×–EƒŠƒ“ƒpŽîiIntravascular large B-cell lymphomaj

ŒŒ‰t‘O‹ě×–EŽîá‡

‰č‹…ŤŒ`Žż×–E—lŽ÷ó×–EŽîᇁiBlastic plasmacytoid dendritic cell neoplasmj


–FŽb’č“IŽžŠł’PˆĘC”FVWHO •Ş—Ţ‚Ĺ‚Í‚Ń‚Ü‚ńŤ‘ĺ×–EŒ^B ×–EƒŠƒ“ƒpŽîC”ń“ÁˆŮ‚ÉŠÜ‚Ü‚ę‚éB

iWHO-EORTC •Ş—Ţ2005 ”N‚đ‚ŕ‚Ć‚ÉWHO •Ş—Ţ2008 ”N‚Ě•a–ź‚đĚ—pj

‰đŕ

2005 ”N‚É”­•\‚ł‚ę‚˝”畆ˆŤŤƒŠƒ“ƒpŽî‚ĚWHO-EORTC •Ş—ށi2005 ”Nj1j‚đ‚ŕ‚ƂɁC2008 ”N‚É‘˘ŒŒŒnŽîᇂ̐V•Ş—Ţ‚Ş’ńĽ‚ł‚ęC”畆ƒŠƒ“ƒpŽî‚̐f’f•a–ź‚ŞŽáŠą•ĎX‚ł‚ę‚˝2jBƒŠƒ“ƒpŽî•Ş—Ţ‚Ě•Ď‘J‚ÍJaffe ‚ç‚Ě‘ŕ‚ɏڂľ‚˘3jB

WHO •Ş—Ţ‘ć4 ”Łi2008 ”Nj‚ł́C–{–M‚đŠÜ‚ŢƒAƒWƒACƒƒLƒVƒRCƒyƒ‹[‚Š‚ç•ń‚Ě‚ ‚éŽí“——l…ávÇ—lƒŠƒ“ƒpŽî‚Ş“Ć—§ŽžŠł‚Ć‚ľ‚ĐV‚˝‚ɉÁ‚Ś‚ç‚ę‚˝BB ×–EƒŠƒ“ƒpŽî‚ł́CŒ´”­Ť”畆•Ó‰‘ŃB ×–EƒŠƒ“ƒpŽîiPrimary cutaneous marginal zone B-cell lymphomaj‚Ě•a–ź‚Š‚çuprimary cutaneousv‚ލ폜‚ł‚ęCßŠOŤ•Ó‰‘ŃƒŠƒ“ƒpŽîiMALT ƒŠƒ“ƒpŽîjiExtranodal marginalzone lymphoma of mucosa-associated lymphoid tissuej‚É‚Ü‚Ć‚ß‚ç‚ę‚˝B‚Ü‚˝C‚ą‚ę‚Ü‚ĹCD4 { /CD56 { hematodermic neoplasm iBlastic NK-cell lymphomaj‚ĆŒÄĚ‚ł‚ę‚Ä‚Ť‚˝Žîᇂ́C‚ť‚Ě—R—ˆ‚Şplasmacytoid dendritic cell ‘O‹ě×–E‚ƍl‚Ś‚ç‚ę‚é‚˝‚߁CBlastic plasmacytoid dendritic cell neoplasm ‚Ɖü•Ď‚ł‚ę‚˝B

•śŒŁ

1j Willemze R, Jaffe ES, Burg G, et al: WHO-EORTC classification for cutaneous lymphomas, Blood, 2005; 105: 3768-3785.

2j WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Ed. Swerdlow, SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW. IARC Press, Lyon, 2008.

3j Jaffe ES, Harris NL, Stein H, Isaacson PG: Classification of lymphoid neoplasms:the microscope as a tool for disease discovery, Blood, 2008; 112: 4384-4399.



2D—pŒę‚Ě’č‹`

‹Űó‘§“÷Ç‚âSézary ÇŒóŒQ‚đ‘ă•\‚Ć‚ˇ‚é”畆ƒŠƒ“ƒpŽî‚̔畆•a•Ď‚đ‹LÚ‚ˇ‚é—pŒę‚ɂ̓Rƒ“ƒZƒ“ƒTƒX‚Ş•K—v‚Ć‚ł‚ę‚Ä‚Ť‚˝B“ˆę‚ł‚ę‚˝—pŒę‚đ—p‚˘‚Č‚Ż‚ę‚΁CłŠm‚Č•aŠú‚đŒˆ’č‚ˇ‚é‚ą‚Ć‚Í‚Ĺ‚Ť‚¸C—\Œă‰đÍ‚É‚ŕ‚΂ç‚‚Ť‚𐜂ś‚éBISCL ‚𒆐S‚É‚ľ‚ÄˆČ‰ş‚̂悤‚É—pŒę‚đ’č‹`‚ľ‚˝B–{ƒKƒCƒhƒ‰ƒCƒ“‚É‚ŕ‚ą‚Ě—pŒę’č‹`‚đĚ—p‚ľ‚˝B

‹Űó‘§“÷Ç‚̍g”Áipatchj‚Ƌǖʁiplaquej‚́C—˛‹N‚ ‚邢‚͐Z‚Ě—L–ł‚É‚ć‚Á‚Ä‹ć•Ę‚ł‚ę‚éB’ˆÓ‚ˇ‚ׂŤ‚́C”畆•a•Ď‚Ě‘ĺ‚Ť‚ł‚âC‘gDŠŒŠ‚Í”ť’čŢ—ż‚ɉÁ‚Ś‚Ä‚˘‚Č‚˘‚ą‚ƁC–Ń•ďˆę’vŤ”ç]‚ŞŽĺ‘Ě‚Ĺ‚ ‚ę‚Î‹Ç–Ę‚Ćl‚Ś‚é“_‚Ĺ‚ ‚é1jB

‹Űó‘§“÷Ç‚́uŽîᎁvŤ•a•Ď‚Ě’č‹`‚́C1 cm ˆČă‚ĚŽî᎐Ť•a•ĎC‚ ‚邢‚Í’×ᇂ𔺂¤‹Ç–ʂŐ[’BŤ‚Ü‚˝‚͐‚’ź•űŒü‚Ö‚Ě‘B‚đŽŚ‚ˇ‚ŕ‚Ě‚Ć’č‹`‚ł‚ę‚˝BÁ‘Ţ‚đŒJ‚č•Ô‚ˇ‚悤‚ČƒŠƒ“ƒpŽî—l‹u]Ç‚̂悤‚Č‹u]Ť•a•Ď‚ÍŽîᎂŠ‚珜ŠO‚ł‚ę‚é‚ą‚Ć‚É‚Č‚éB

g”çÇ‚́C–{—ˆ‚Í100“‚̔畆•a•Ď‚đˆÓ–Ą‚ˇ‚é‚ŞCƒŠƒ“ƒpŽîÇ—á‚Ĺ‚Í•K‚¸‚ľ‚ŕ100“‚Ě•a•Ď‚Ĺ‚Č‚­‚Ä‚ŕ”’ŒŒ‰ť‚đŽŚ‚ˇÇ—á‚Ş‚Ý‚ç‚ę‚é‚˝‚߁C‘Ě•\–ʐςĚ80“ˆČă‚Ě•a•Ď‚đ‚ŕ‚Á‚čg”çÇ‚Ć’č‹`‚ł‚ę‚˝B

Sézary ÇŒóŒQ‚́Cg”çÇ‚Ć–ž‚ç‚Š‚Č”’ŒŒ‰ť‚đ—L‚ˇ‚éT ×–EƒŠƒ“ƒpŽî‚Ĺ‚ ‚é‚ŞCu–ž‚ç‚Š‚ȁv”’ŒŒ•a‚ɂ‚˘‚ẮCĹ‹ß‚̐f’f‹Zp‚đ‚Ƃ肢‚ę‚āCB0, B1, B2 Šî€‚đĚ—p‚ľ‚āCŒăqi•aŠú•Ş—Ţ‚đŽQĆj‚̂悤‚ɍĒč‹`‚ł‚ę‚˝2jB

‘Šú‚Ě‹Űó‘§“÷Ç‚̐f’fŠî€‚ɂ‚˘‚ẮC‹Ç–ʏó—ŢŠŁá‚Ć‚ĚˆŮ“Ż‚Ş‹c˜_‚ł‚ę‚Ä‚˘‚éB—\Œă‚đdŽ‹‚ľ‚āu—ŢŠŁáv‚Ć‚˘‚¤•a–ź‚đŽc‚ˇ‚ŠC‚ ‚邢‚Í—Ő°E•a—‘gDŠw“I‚É‹ć•Ę‚ނ‚Š‚Č‚˘“_‚đl—ś‚ľ‚āu‹Űó‘§“÷Çv‚̐is‚ދɂ߂Ċɏ™‚ŠCÁ‘Ţ‚ˇ‚é—á‚Ć‚Ć‚ç‚Ś‚錊‰đ‚Ş‚ ‚éBRetrospective ‚É‚ľ‚Š”ť’f‚Ĺ‚Ť‚Č‚˘‚Ě‚Ĺ‚Í—Ő°‚É‚¨‚˘‚ÄŽŔ—p“I‚Ĺ‚Í‚Č‚˘‚˝‚߁C‘Šú‹Űó‘§“÷Ç‚̐f’fŠî€‚Ş’ńĽ‚ł‚ę‚˝3jB

‹Űó‘§“÷Ç‚É large cell transformationi—pŒę’č‹`‚Ě•\‚đŽQĆj‚đ‚Ť‚˝‚ˇ‚ą‚Ć‚Ş‚ ‚čC—\Œă•s—Ç‚ĚƒTƒCƒ“‚Ć‚ł‚ę‚Ä‚˘‚éBłíƒŠƒ“ƒp‹…‚Ě4 ”{ˆČă‚Ě‘ĺ‚Ť‚ł‚ĚŽîᇍזE‚ށCZ×–E‚Ě25“ˆČă‚Ěę‡‚âCŒ°”÷‹ž“I‚ÉŒ‹ßŤ‘B‚đŽŚ‚ˇ‚Ć‚Ťę‡‚Ć’č‹`‚ł‚ę4jCCD30 —zŤ‚É‚Č‚é‚ą‚Ć‚Ş‘˝‚˘‚Ş•K‚¸‚ľ‚ŕ—zŤ‚Ĺ‚ ‚é•K—v‚Í‚Č‚˘B‹Űó‘§“÷Ç‚É‚Ý‚ç‚ę‚郊ƒ“ƒpŽî—l‹u]Ç—l”ç]‚É‚Ý‚ç‚ę‚éCD30 —zŤ‚Ě‘ĺŒ^×–EoŒť‚Ćlarge cell transformation ‚đ“Ż‹`‚Ɉľ‚Á‚Ă悢‚Š‚Ç‚¤‚Š‚Í–žŠm‚É‚ł‚ę‚Ä‚˘‚Č‚˘B

”畆T ×–EƒŠƒ“ƒpŽî‚Ě—pŒę’č‹`

•a@•Ď

’č@‹`

g”ÁiPatchj –ž‚ç‚Š‚Ȑˇ‚čă‚Ş‚č‚âZ‚Ě‚Č‚˘•a•Ď‚ŁC‘ĺ‚Ť‚ł‚Í–â‚í‚Č‚˘BF‘fˆŮíC—Ř‹űCáo”ç‚âá°ĺü‚𔺂¤‚ą‚Ć‚Ş‚ ‚éB
‹Ç–ʁiPlaquej ˇ‚čă‚Ş‚č‚âZ‚Ě‚ ‚é•a•Ď‚ŁC‘ĺ‚Ť‚ł‚Í–â‚í‚Č‚˘BF‘fˆŮíC—Ř‹űCáo”ç‚â–ѕ•a•Ď‚𔺂¤‚ą‚Ć‚Ş‚ ‚éB
ŽîᎁiTumorj 1 cm ˆČă‚ĚŒÇ—§Ť‚Č‚˘‚ľŒ‹ßŤ•a•Ď‚ŠC’×ᇌ`Ź‚ľ‚˝‹Ç–ʂŁC[’BŤ‚Ü‚˝‚͐‚’ź•űŒü‚Ö‚Ě‘B‚đŽŚ‚ˇB
g”çÇ ‘Ě•\–ʐςĚ80“ˆČă‚Ě—Z‡‚ľ‚˝g”ÁŤ•a•Ď
g”çÇŒ^
‹Űó‘§“÷Ç
–ž‚ç‚Š‚ČŒŒ‰tŠw“IˆŮí‚𔺂í‚Č‚˘g”çÇ
Sézary ÇŒóŒQ —Տ°“I‚É–ž‚ç‚Š‚ČŒŒ‰tŠw“IˆŮí‚𔺂¤g”çÇ
iˆČăCISCL: International Society for Cutaneous Lymphoma ‚Ě’ńĽj
i•â‘Ťŕ–žj
Large cell
transformation
ŹƒŠƒ“ƒp‹…‚Ě4 ”{ˆČă‚Ě‘ĺŒ^ƒŠƒ“ƒp‹…‚ށCZ×–E‚Ě25“ˆČă‚É‚Ý‚ç‚ę‚é‚ŠCŒ°”÷‹ž“I‚ɏŹŒ‹ßó‚É‘B‚ľ‚Ä‚˘‚éó‘ԁBCD30 —zŤ‚É‚Č‚é‚ą‚Ć‚Ş‘˝‚˘‚ށC‰AŤ—á‚ŕ‚Ý‚ç‚ę‚éB

iDiamandidou E et al, Blood, 1998 ‚Ě’č‹`j

•śŒŁ

1j Kim EJ, Hess S, Richardson SK, et al: Immunopathogenesis and therapy of cutaneous T cell lymphoma, J Clin Invest, 2005; 115: 789-812.

2j Vonderheid EC, Bernengo MG, Burg G, et al: Update on erythrodermic cutaneous T-cell lymphoma: Report of the International Society for Cutaneous Lymphomas, J Am Acad Dermatol, 2002; 46: 95-106.

3j Pimpinelli N, Olsen EA, Santucci M, et al: Defining early mycosis fungoides, J Am Acad Dermatol, 2005; 53: 1053-1061.

4j Diamandidou E, Colome-Grimmer M, Fayad L, et al: Transformation of Mycosis fungoides/Sezary syndrome: Clinical characteristics and prognosis, Blood, 1998; 92: 1150-1159.

‹Űó‘§“÷ÇESézary ÇŒóŒQ‚ĚTNMB •Ş—Ţ


T1F

‘Ě•\–ʐςĚ<10“

T1aipatch ‚ž‚ŻjCT1biplaque { patchj

T2F

‘Ě•\–ʐςĚ≥10“

T2aipatch ‚ž‚ŻjCT2biplaque { patchj

T3F

Žîᎌ`Ź@@1 •a•Ď‚Ü‚˝‚Í‚ť‚ęˆČă 

T4F

g”çÇ@@@‘Ě•\–ʐςĚ80“ˆČă‚Ě—Z‡‚ˇ‚ég”Á


N0F

—Տ°“I‚ÉˆŮíƒŠƒ“ƒpß‚Č‚ľBśŒŸ•s—v 

N1F

—Տ°“I‚ÉˆŮíƒŠƒ“ƒpß‚ ‚čB

‘gDŠw“I‚ÉDutch Gr1, or NCI LN0-2 ‚É‘Š“–*

N1aFƒNƒ[ƒ“Ť‘B‚Č‚ľ@N1bFƒNƒ[ƒ“Ť‘B‚ ‚č

N2F

—Տ°“I‚ÉˆŮíƒŠƒ“ƒpß‚ ‚čB

‘gDŠw“I‚ÉDutch Gr 2, or NCI LN3 ‚É‘Š“–*

N2aFƒNƒ[ƒ“Ť‘B‚Č‚ľ N2b: ƒNƒ[ƒ“Ť‘B‚ ‚č

N3F

—Տ°“I‚ÉˆŮíƒŠƒ“ƒpß‚ ‚čB

‘gDŠw“I‚ÉDutch Gr 3`4, or NCI LN4 ‚É‘Š“–*

NxF

—Տ°“I‚ÉˆŮíƒŠƒ“ƒpß‚ ‚é‚ŞC‘gD“IŠm”F‚Č‚˘‚ŠCŠŽ‘S‚ČN •Ş—Ţ‚Ş‚Ĺ‚Ť‚Č‚˘B


M0F

“ŕ‘Ÿ•a•Ď‚Č‚ľ@M1: “ŕ‘Ÿ•a•Ď‚ ‚č


B0F

ˆŮŒ^ƒŠƒ“ƒp‹…‚Ş––˝ŒŒƒŠƒ“ƒp‹…‚Ě5“ ˆČ‰ş

B0aFƒNƒ[ƒ“Ť‘B‰AŤCB0bFƒNƒ[ƒ“Ť‘B—zŤ

B1F

ˆŮŒ^ƒŠƒ“ƒp‹…‚Ş––˝ŒŒƒŠƒ“ƒp‹…‚Ě5“ ‚đ’´‚Ś‚é‚ŞCB2Šî€‚đ–ž‚˝‚ł‚Č‚˘B

B1aFƒNƒ[ƒ“Ť‘B‰AŤCB1bFƒNƒ[ƒ“Ť‘B—zŤ

B2F

Sézary ×–EiƒNƒ[ƒ“Ť‘B‚ ‚čj ‚Ş––˝ŒŒ’†‚É1000 ŒÂ/uL ˆČăBSézary ×–E‚ŞˆČ‰ş‚̍€–Ú‚Ě1 €–Ú‚đ–ž‚˝‚ˇFCD4/CD8≥10, CD4 { CD7- ×–E ≥ 40“C‚Ü‚˝‚ÍCD4 { CD26- ×–E ≥ 30“B

•aŠú T N M B
ⅠA 1 0 0 0,1
ⅠB 2 0 0 0,1
ⅡA 1`2 1,2, X 0 0,1
ⅡB 3 0`2, X 0 0,1
ⅢA 4 0`2, X 0 0
ⅢB 4 0`2, X 0 1
ⅣA1 1`4 0`2, X 0 2
ⅣA2 1`4 3 0 0`2
ⅣB 1`4 0`3, X 1 0`2

XF

—Տ°“I‚ÉˆŮí‚ČƒŠƒ“ƒpßŽî‘ĺ‚ŞC‘gDŠw“I‚ÉŠm”F‚ł‚ę‚Ä‚˘‚Č‚˘‚ŠCŠŽ‘S‚ČN •Ş—Ţ‚Ş‚Ĺ‚Ť‚Č‚˘B


–ƒŠƒ“ƒpß‚ĚNCI •Ş—ށi‹Œ•Ş—ŢŠî€j

NCI LN0F
ƒŠƒ“ƒpß‚ÉˆŮŒ^ƒŠƒ“ƒp‹…‚Č‚ľB 
NCI LN1F
ŠXCŒÇ—§ŤˆŮŒ^ƒŠƒ“ƒp‹…iW‰ň‚đě‚ç‚Č‚˘j 
NCI LN2F
‘˝”‚ĚˆŮŒ^ƒŠƒ“ƒp‹…‚Ü‚˝‚Í3`6 ×–E‚̏ŹW‰ň 
NCI LN3F
ˆŮŒ^ƒŠƒ“ƒp‹…‚Ě‘ĺ‚Ť‚ȏW‰ň‚ ‚é‚ŞCƒŠƒ“ƒpß‚ĚŠî–{\‘˘‚Í•Ű‚˝‚ę‚éB 
NCI LN4F
ƒŠƒ“ƒpß\‘˘‚ŞˆŮŒ^ƒŠƒ“ƒp‹…‚Ü‚˝‚ÍŽîᇍזE‚É‚ć‚Á‚Ä•”•Ş“I‚ ‚邢‚ÍŠŽ‘S‚É’uŠˇ‚ł‚ę‚éB

3D•aŠú•Ş—Ţ

1j‹Űó‘§“÷ÇESézary ÇŒóŒQ‚Ě•aŠú•Ş—ށiISCL/EORTC 2007 ”N, ‰ü’ů2011 ”Nj

‹Űó‘§“÷ÇESézary ÇŒóŒQ‚Ě•aŠú‚́CBunn ‚ç1jCSausville ‚ç2j‚Ě•Ş—Ţ‚Ş—p‚˘‚ç‚ę‚Ä‚Ť‚˝‚ށC2007 ”N‚ÉISCL/EORTC •Ş—Ţ‚ŞŽŚ‚ł‚ę3jC2011 ”N‚ɏCł‚ł‚ę‚˝4jB

]—ˆ‚Ě•Ş—Ţ‚Š‚ç‚Ě‘ĺ‚Ť‚Č•ĎX“_‚́C1jŒŒ‰tŠŒŠ‚Ěˆľ‚˘‚ƁC2jƒŠƒ“ƒpß•a•Ď‚Ěˆľ‚˘‚Ĺ‚ ‚éB––˝ŒŒ‚ĚˆŮŒ^ƒŠƒ“ƒp‹…‚đ•\‚̂悤‚ÉB0i––˝ŒŒƒŠƒ“ƒp‹…‚Ě5“ˆČ‰şjCB1i––˝ŒŒƒŠƒ“ƒp‹…‚Ě5“‚đ’´‚Ś‚é‚Ş––˝ŒŒ’†‚É1,000/ ƒĘ L –˘–žjCB2i––˝ŒŒ’†‚É1,000/ ƒĘ L ˆČăj‚Ć‹ć•Ę‚ľCg”çÇ‚ɉÁ‚Ś‚ÄB2 Šî€‚đ–ž‚˝‚ˇ‚ŕ‚Ě‚đSézary ÇŒóŒQ‚Ć‚ľ‚˝BB2 Šî€‚ɂ́Cflow cytometryiFACS ‰đÍj‚ɂāCCD4/8 ”äF„ 10CCD4 { CD7-F„ 40“CCD4 { CD26-F„ 30“‚Ě‚˘‚¸‚ę‚Š‚đ–ž‚˝‚ˇ‚ŕ‚Ě‚Ć‚ł‚ę‚˝5, 6jB

ƒŠƒ“ƒpß•a•Ď‚ɂ‚˘‚Ä‚ŕ“ˆę‚ł‚ę‚˝BƒŠƒ“ƒpß‚Ě‘ĺ•”•Ş‚ ‚邢‚Í‘S‘Ě‚ŞŽîᇍזE‚Ĺ’u‚ŤŠˇ‚Ś‚ç‚ę‚˝ę‡‚ɁCN3 ‚Ɛf’f‚ł‚ęCstage Ⅳ‚É•Ş—Ţ‚ł‚ę‚éBƒŠƒ“ƒpß‚ÉˆŮŒ^×–EZ‚Ş‚ ‚Á‚Ä‚ŕŹ•a‘ƒ‚â•”•Ş“IZ‚Ěę‡‚É‚ÍN3 ‚Ƃ͐f’f‚ľ‚Č‚˘7jB

ISCL/EORTC ‚ސ„§‚ˇ‚é•aŠúf’f‚Ě‚˝‚ß‚ĚŒŸ¸


  1. ŠŽ‘S‚ČŠů‰—đ’ŽŽć‚Ć—Šw“IfŽ@
  2. —Տ°ŒŸ¸
    ––˝ŒŒ‹…”, ŒŒ´ś‰ťŠwŒŸ¸, ŒŒ´ LDH
    “K‰ž‚Ş‚ ‚ę‚Ζ–˝ŒŒflow@cytometry ŒŸ¸
  3. ‰ć‘œŒŸ¸*
    ‹š•”C• •”Cœ”Ő‚Ě‘˘‰eCT ŒŸ¸C‚Ü‚˝‚ÍFDG ‚đ—p‚˘‚˝‘SgPET
    —Տ°“I“K‰ž‚Ş‚ ‚ę‚ÎCT ŒŸ¸‚ ‚邢‚Í’´‰š”gŒŸ¸
    •W€“I‘˘‰eCT ‚É‘ă‚í‚錟¸‚Ć‚ľ‚ÄPET/CT
  4. œ‘śŒŸ‚ƐúŽh
    WHO-EORTC •Ş—Ţ‚Ěintermediate ‚Š‚çaggressive ‚É•Ş—Ţ‚ł‚ę‚é•aŒ^‚É“K‰ž
    Indolent ‚̔畆ƒŠƒ“ƒpŽî‚É‚ŕl—ś‚ˇ‚ׂŤ‚ž‚ށC‘ź‚Ě•aŠúf’f‚Ĺ“K‰ž‚Ş‚Č‚Ż‚ę‚Εs—v
  5. —Տ°“I“K‰ž‚ɉž‚ś‚ĒljÁŒŸ¸

*  ’ZŒa‚Ĺ1cm ‚đ’´‚Ś‚郊ƒ“ƒpß‚âC–ž‚ç‚Š‚ÉPET ŒŸ¸‚ĹŠˆ“ŽŤ‚Ş‚ ‚郊ƒ“ƒpß‚Í‘gDŒŸ¸‚Ě‚˝‚ß‚ÉĚŽć‚ˇ‚ׂŤi‰Â”\‚ČŒŔ‚č“EośŒŸ‚ލD‚Ü‚ľ‚˘jB

‹Űó‘§“÷ÇESézary ÇŒóŒQˆČŠO‚̔畆ƒŠƒ“ƒpŽî‚ĚTNM •Ş—Ţ


TFT1F

’P”­‚̔畆•a•Ď

T1aF’P”­‚Ě•a•Ď@@< ’źŒa5 cm
T1bF’P”­‚Ě•a•Ď@@> ’źŒa5 cm

T2F

ŒŔ‹ÇŤ”畆•a•Ď: ‘˝”­Ť•a•Ď‚Ş1 ‚‚Ȃ˘‚ľ˜A‘ą‚ľ‚˝2 ‚‚̐g‘Ě•”ˆĘ* ‚ÉŒŔ‹Ç

T2aF‚ˇ‚ׂĂ̕a•Ď•”ˆĘ‚Ş’źŒa15 cm –˘–ž‚̉~Œ`—Ěˆć‚ÉŠÜ‚Ü‚ę‚é
T2bF‚ˇ‚ׂĂ̕a•Ď•”ˆĘ‚Ş’źŒa15 cm ’´‚Ĺ30 cm –˘–ž‚̉~Œ`—Ěˆć‚ÉŠÜ‚Ü‚ę‚é
T2cF‚ˇ‚ׂĂ̕a•Ď•”ˆĘ‚Ş’źŒa30 cm ‚̉~Œ`—Ěˆć‚đ’´‚Ś‚é

T3F

”Ä”­Ť”畆•a•Ď

T3aF‘˝”­Ť•a•Ď‚Ş”ń˜A‘ąŤ‚Ě2 g‘Ě—Ěˆć‚É‚Ý‚ç‚ę‚é
T3bF‘˝”­Ť•a•Ď‚Ş3 g‘Ě—Ěˆć‚É‚Ý‚ç‚ę‚é

NFN0F

—Տ°“I‚¨‚ć‚Ń•a—Šw“I‚ɃŠƒ“ƒpß•a•Ď‚Č‚ľ 

N1F

ŒťÝ‚ ‚邢‚ÍˆČ‘O‚̔畆•a•Ď‚Ě1 ‚Â‚ĚŠ‘ŽƒŠƒ“ƒpß—Ěˆć‚Ě•a•Ď 

N2F

ŒťÝ‚ ‚邢‚ÍˆČ‘O‚̔畆•a•Ď‚Ě2 ‚‚Ȃ˘‚ľ‚ť‚ęˆČă‚Ě––˝ƒŠƒ“ƒpß—Ěˆć•a•Ď 

N3F

’†•Ťi[ÝŤjƒŠƒ“ƒpß•a•Ď 

MFM0F

”畆ŠO‚É”ńƒŠƒ“ƒpß•a•Ď‚đ”F‚ß‚Č‚˘ 

M1F

”畆ŠO‚É”ńƒŠƒ“ƒpß•a•Ď‚đ—L‚ˇ‚é 

*  lŒ`}ŽQĆ

T •Ş—Ţ‚Ě‚˝‚߂̐lŒ`}
2j‹Űó‘§“÷ÇESézaryÇŒóŒQˆČŠO‚̔畆ƒŠƒ“ƒpŽî‚ĚTNM •Ş—ށiISCL/EORTC 2007 ”Nj

‹Űó‘§“÷ÇESézary ÇŒóŒQˆČŠO‚ĚŒ´”­Ť”畆ƒŠƒ“ƒpŽî‚ɂ́C”畆•a•Ď‚đ•]‰ż‚ˇ‚é‚Ě‚É“K‚ľ‚˝TNM •Ş—Ţ‚Ş‚Č‚Š‚Á‚˝‚ށC2007 ”N‚ÉISCL ‚ĆEORTC ‚́CV‚˝‚ČTNM •Ş—Ţ‚đ”­•\‚ľ‚˝8jB‚ą‚Ě•Ş—Ţ‚Í•a•Ď‚ĚŠg‚Ş‚č‚đŽŚ‚ˇ‚ą‚Ć‚Í‚Ĺ‚Ť‚Ä‚ŕC‚ł‚Ü‚´‚Ü‚Č•aŒ^‚ŞŠÜ‚Ü‚ę‚Ä‚˘‚é‚˝‚߂ɁC•aŠú•Ş—Ţ‚ÍŽŚ‚ł‚ę‚Ä‚¨‚炸CŠe•aŒ^‚Ě—\Œă‚𔽉f‚ľ‚Ä‚˘‚Č‚˘BĹ‹ßCƒf[ƒ^‚̏WĎ‚ސi‚ß‚ç‚ę‚Ä‚˘‚é‚Ş9jCĄŒăC—Տ°Ç—á‚đĎ‚Ýă‚°‚ÄŠe•aŒ^‚Ĺ‚Ě—\Œă‰đÍ‚đŽ{s‚ľC•aŠú•Ş—Ţ‚đŒˆ’č‚ˇ‚é•K—v‚Ş‚ ‚éB

–‚ť‚Ě‘ź‚̔畆ƒŠƒ“ƒpŽîE‘˘ŒŒŒnŽîᇂ̕aŠú•Ş—Ţ

ßŠOŒ^NK/T ×–EƒŠƒ“ƒpŽîC•@Œ^‚Ɓ@‰č‹…ŤŒ`Žż×–E—lŽ÷ó×–EŽîᇂŕKim YH ‚ç‚ĚTNM •Ş—Ţ8j‚Ş“K‰ž‰Â”\‚ž‚ށC–{–M‚Ĺ‚Í—źŽžŠł‚Ć‚ŕCAnn Arbor •Ş—ށi‚ť‚̏Cł”Ĺ‚ĚCotswolds •Ş—ށji•\j‚đ•Ö‹Xă—p‚˘‚ĉđÍ‚ސi‚ß‚ç‚ę‚Ä‚Ť‚˝‚̂ŁC•Ę€‚Ć‚ľ‚ÄŽć‚čă‚°‚˝BßŠOŒ^NK/T ×–EƒŠƒ“ƒpŽîC•@Œ^‚́C•@ŤƒŠƒ“ƒpŽî‚Ć•@ˆČŠO‚ĚƒŠƒ“ƒpŽî‚É•Ş—Ţ‚ł‚ę‚Ä‚Ť‚˝‚ށC—\ŒăˆöŽq‚ĆŽĄ—Ă“K‰ž‚đl—ś‚ˇ‚éˆÓ–Ą‚ŁC‹ÇÝŒ^‚ƔĔ­Œ^‚É•Ş‚Ż‚ç‚ę‚é10jB

ŹlT ×–E”’ŒŒ•aEƒŠƒ“ƒpŽîiATLLj‚ɂ‚˘‚ẮC‰şŽR‚ç‚Ě•Ş—Ţi‹}ŤCƒŠƒ“ƒpŽîC–ŤC‚­‚ˇ‚Ô‚čŒ^‚Ě4 •Ş—ށj11j‚ލL‚­—p‚˘‚ç‚ę‚Ä‚˘‚é‚ŞC”畆‚Ě‚Ý‚É•a•Ď‚đŒ`Ź‚ˇ‚éu”畆Œ^vATLL ‚Ě’č‹`‚Ć•aŠú‚Ě’čŕ‚Í‚Č‚˘‚Ş, ”畆•a•Ď‚̐Ťó‚Ş—\ŒăˆöŽq‚É‚Č‚č“ž‚é‚Ć‚Ě•ń12j‚Ş‚ ‚čC”畆•a•Ď‚̍L‚Ş‚č‚ž‚Ż‚Ĺ‚Í‚Č‚­C”畆ŠŒŠ‚̐łŠm‚Č‹LÚ‚ޏd—v‚Ĺ‚ ‚éB

ˆŤŤƒŠƒ“ƒpŽî‚Ě•aŠú•Ş—Ţ iCotswolds •Ş—Ţ 1989 ”Nj


Ⅰ Šú

’Pˆę‚ĚƒŠƒ“ƒpß—ĚˆćC’Pˆę‚ĚƒŠƒ“ƒp‘gDiWaldeyer —ւȂǁjiⅠj
‚Ü‚˝‚Í’Pˆę‚ĚƒŠƒ“ƒpßŠO•a•ĎiIEj‚Ě‚˘‚¸‚ę‚Š‚ÉŒŔ‹Ç

ⅡŠú

‰ĄŠu–Œ‚Ě“Ż‚ś‘¤‚Ĺ2 ‚ÂˆČă‚ĚƒŠƒ“ƒpß—ĚˆćCƒŠƒ“ƒp‘gD‚Ě•a•ĎiⅡj
‚Ü‚˝‚͉ĄŠu–Œ‚Ě“Ż‘¤‚Ĺ‚Đ‚Ć‚Â‚ĚƒŠƒ“ƒpß‚Ć‚ť‚ę‚ɐڂˇ‚é‚ЂƂ‚̐ߊO•a•ĎiⅡEj

  • •a•Ď‚Ě‚ ‚郊ƒ“ƒpß—Ěˆć”‚đ‹LÚi—áFⅡ2j
  • cŠu‚Ě•Đ‘¤”x–ĺƒŠƒ“ƒpß‚Í‚ť‚ę‚ź‚ę‚Đ‚Ć‚Â‚ĚƒŠƒ“ƒpß—Ěˆć‚Ć‚ˇ‚é
ⅢŠú

‰ĄŠu–Œ‚Ě—ź‘¤‚É‚¨‚Ż‚郊ƒ“ƒpß—ĚˆćCƒŠƒ“ƒp‘gD‚Ě•a•Ď
1F‰ĄŠu–Œ‰ş‚Íă• •”‚ÉŒŔ‹ÇiäB‘ŸCäB–ĺ•”C• oC–ĺ–ŹƒŠƒ“ƒpßj
2F‰ĄŠu–Œ‰ş‚Íă• •”‚É‚¨‚ć‚ԁi–T‘ĺ“Ž–ŹC’°œC’°ŠÇ–ŒƒŠƒ“ƒpßj

  • äB•a•ĎCßŠO•a•ĎC—źŽŇ‚Í‚ť‚ę‚ź‚ęⅢsCⅢECⅢsE ‚̂悤‚É‹LÚ
‡WŠú

ƒŠƒ“ƒpßˆČŠO‚Ě‘gDC‘ŸŠíiäB‘Ÿ‚Ć‹š‘B‚̓Šƒ“ƒp‘gD‚Ĺ‚ ‚čC‚ą‚ą‚Ĺ‚ÍœŠO‚ł‚ę‚éj‚Ö‚Ě‚Ń‚Ü‚ńŤ‚Č‚˘‚ľ”dŽíŤZ‚Ş‚ ‚éę‡‚ŁCƒŠƒ“ƒpß•a•Ď‚Ě—L–ł‚Í–â‚í‚Č‚˘

  • Še•aŠú‚É‘SgÇó‚Ě—L–ł‚đ•t‹L

    AF‘SgÇó‚Ş‚Č‚˘ę‡i—áF‡TAj

    BF ‘SgÇó‚Ş‚ ‚éę‡i—áF‡WBj
    ‘SgÇóF①”­•a‘O6 ƒJŒŽŠÔ‚É10“ˆČă‚ĚŒ´ˆö•s–ž‚Ě‘ĚdŒ¸­C②38ŽˆČă‚ĚŒ´ˆö•s–ž‚Ě”­”MC③“Šž

  • bulky •a•Ďi‹šŠs“ŕŒa‚Ěl/3 ˆČă‚̏cŠuŽîᎁC‚ť‚Ě‘ź‚Ě•”ˆĘ‚Ě10cm ˆČă‚ĚŽîᎁj‚É‚ÍX ‚đ‚‚Ż‚éi—áFⅡXj
  • ßŠOŤ•a•Ď‚É‚ÍE ‚đ‚‚Ż‚éi—áFⅡEj
•śŒŁ

1j Bunn PA Jr, Lamberg SI: Report of the Committee on Staging and Classification of Cutaneous T-cell Lymphomas, Cancer Treat Rep, 1979; 63: 725-728.

2j Sausville EA, Eddy JL, Makuch RW, et al: Histopathologic staging at initial diagnosis of mycosis fungoides and Sezary syndrome. Definition of three distinctive prognostic groups, Ann Intern Med, 1988; 109: 372-382.

3j Olsen E, Vonderheid E, Pimpinelli N, et al: Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas iISCLj and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer iEORTCj, Blood, 2007;110:1713-1722.

4j Olsen EA, Whittaker S, Kim YH, et al: Clinical End Points and Response Criteria in Mycosis Fungoides and Sezary Syndrome: A Consensus Statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer, J Clin Oncol, 2011; 29: 2598-2607.

5j Vonderheid EC, Bernengo MG, Burg G, et al: Update on erythrodermic cutaneous T-cell lymphoma: Report of the International Society for Cutaneous Lymphomas, J Am Acad Dermatol, 2002; 46: 95-106.

6j Olsen EA, Whittaker S, Kim YH, et al: Clinical End Points and Response Criteria in Mycosis Fungoides and Sezary Syndrome: A Consensus Statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer, J Clin Oncol. 2011; 29: 2598-2607.

7j ó‰zŒ’ŽĄF”畆ƒŠƒ“ƒpŽî‚̐f’f“IŒŸ¸‚̐i‚ß•ű: ƒŠƒ“ƒpßśŒŸ‚Ć‚ť‚ĚŽć‚čˆľ‚˘C“ú”ç‰ďŽ@2007; 117F2169-2172.

8j Kim YH, Willemze R, Pimpinelli N, et al: TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas iISCLj and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of CanceriEORTCj, Blood, 2007 ; 110: 479-484.

9j Senff NJ, Willemze R: The applicability and prognostic value of the new TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: results and comparison with the system used by the Dutch Cutaneous Lymphoma Group, Br J Dermatol, 2007; 157: 1205-1211.

10j Suzuki R, Suzumiya J, Yamaguchi M, et al: Prognostic factors for mature natural killeriNKj cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type, Ann Oncol, 2010; 21: 1032-1040.

11j Shimoyama M: Diagnostic criteria and classification of clinical subtypes of adult T-cell leukemia-lymphoma. A report from the Lymphoma Study Groupi1984-87j, Br J Haematol, 1991; 79: 428-437.

12j Sawada Y, Hino R, Hama K, et al: Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia/lymphoma, Blood, 2011; 117: 3961-3967.

4D—\Œă‰đÍ

1j‹Űó‘§“÷ÇESézary ÇŒóŒQ

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10 ”Nś‘ś—Ś 88 70 52 34 37 25 18 15 NR *
20 ”Nś‘ś—Ś 73 52 47 21 25 NR * 15 03 NR *
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ŽžŠł“ÁˆŮ“I10 ”Nś‘ś—Ś 95 77 67 42 45 45 20 20 NR *
ŽžŠł“ÁˆŮ“I20 ”Nś‘ś—Ś 90 67 60 29 31 NR * 17 06 NR *
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•aóis—Śi10 ”Nj 12 38 33 58 62 73 83 80 NR *
•aóis—Śi20 ”Nj 18 47 41 71 74 NR * 86 94 NR *
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2j‹Űó‘§“÷ÇESézary ÇŒóŒQˆČŠO‚ĚŒ´”­Ť”畆T/NK ƒŠƒ“ƒpŽî

‹Űó‘§“÷ÇESézary ÇŒóŒQˆČŠO‚̔畆ƒŠƒ“ƒpŽî‚ɂ‚˘‚ẮC2007 ”N‚É‚Í‚ś‚ß‚Ä•a•Ď‚ĚŠg‚Ş‚č‚đ’č‹`‚ˇ‚é‚˝‚ß‚Ě•aŠú•Ş—Ţ‚Ş”­•\‚ł‚ę‚˝‚Ş3jC‚ŕ‚Ć‚ŕ‚Ć‘˝Ží‚Ě•aŒ^‚̏W’c‚Ĺ‚ ‚čC•aŠú•Ş—Ţ‚Ć—\Œă‚Ć‚Í•K‚¸‚ľ‚ŕŠÖ˜A‚š‚¸C5 ”Nś‘ś—Ś‚ÍŠe•aŒ^‚Ĺ‘ĺ‚Ť‚­ˆŮ‚Č‚é‚̂Łi•\2j4jCŒÂX‚Ě•aŒ^‚Ĺ—\Œă‰đÍ ‚đs‚Á‚Ä‚˘‚­•K—v‚Ş‚ ‚éB

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B ×–EƒŠƒ“ƒpŽî‚̐f’fŠî€‚ŞŠm’č‚ľC‚ť‚ę‚ɏ€‹’‚ľ‚˝—\Œă‰đÍ‚Ş•ń‚ł‚ę‚Ä‚˘‚éi•\4jB‘ĺ‚Ť‚­indolent ‚Ćintermediate ŒQ‚É•Ş‚Ż‚é‚ą‚Ć‚Ş‰Â”\‚ŁC‘OŽŇ‚É‚Ífollicle center lymphoma ‚Ćmarginal zone B-cell lymphoma ‚ŞŠÜ‚Ü‚ęCŒăŽŇ‚É‚Ídiffuse large B-cell lymphoma ‚Ş“ü‚é4, 16jB

•\‚S@Œ´”­Ť”畆B ×–EƒŠƒ“ƒpŽî‚Ě•aŒ^‚Ć—\ŒăiSenff NJ ‚ç16jj
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2j Agar NS, Wedgeworth E, Crichton S, et al: Survival outcomes and prognostic factors in mycosis fungoides/ Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal, J Clin Oncol, 2010; 28: 4730-4739.

3j Kim YH, Willemze R, Pimpinelli N, et al: TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous LymphomasiISCLjand the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of CanceriEORTCj, Blood, 2007; 110: 479-484.

4j Willemze R, Jaffe ES, Burg G, et al: WHO-EORTC classification for cutaneous lymphomas, Blood, 2005; 105: 3768-3785.

5j Senff NJ, Willemze R: The applicability and prognostic value of the new TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome: results and comparison with the system used by the Dutch Cutaneous Lymphoma Group, Br J Dermatol, 2007; 157: 1205-1211.

6j é–쏹‹`FŹlT ×–E”’ŒŒ•a/ ƒŠƒ“ƒpŽî‚̔畆•a•ĎCDerma, 2003; 71: 40-46.

7j Bittencourt AL, da Graças Vieira M, Brites CR, et al: Adult T-cell leukemia/lymphoma in Bahia, Brazil: analysis of prognostic factors in a group of 70 patients, Am J Clin Pathol, 2007; 128: 875-882.

8j Sawada Y, Hino R, Hama K, et al: Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia/lymphoma, Blood, 2011; 117: 3961-3967.

9j Benner MF, Willemze R: Applicability and prognostic value of the new TNM classification system in 135 patients with primary cutaneous anaplastic large cell lymphoma, Arch Dermatol, 2009; 145: 1399-1404.

10j Willemze R, Jansen PM, Cerroni L, et al: Subcutaneous panniculitis-like T-cell lymphoma: definition, classification, and prognostic factors: an EORTC Cutaneous Lymphoma Group Study of 83 cases, Blood, 2008; 111: 838-845.

11j Oshimi K, Kawa K, Nakamura S, et al: NK-cell neoplasms in Japan, Hematology, 2005; 10: 237-245.

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13j Bekkenk MW, Jansen PM, Meijer CJLM, Willemze R: CD56 { hematological neoplasms presenting in the skin: a retrospective analysis of 23 new cases and 130 cases from the literature, Ann Oncol, 2004; 15; 1097-1108.

14j Suzuki R, Nakamura S, Suzumiya J, et al: Blastic natural killer cell lymphoma/leukemia iCD56-positive blastic tumorj. Prognostication and categorization according to anatomic sites of involvement, Cancer, 2005; 104: 1022-1031.

15j Bekkenk MW, Jansen PM, Meijer CJLM, Willemze R: CD56 { hematological neoplasms presenting in the skin: a retrospective analysis of 23 new cases and 130 cases from the literature, Ann Oncol, 2004; 15; 1097-1108.

16j Senff NJ, Hoefnagel JJ, Jansen PM, et al: Reclassification of 300 primary cutaneous B-cell lymphomas according to the new WHO-EORTC classification for cutaneous lymphomas: Comparison with previous classifications and identification of prognostic markers. J Clin Oncol, 2007; 25: 1581-1587.