老年人足部血管肉瘤

报告1例老年人足部血管肉瘤.患者男,73岁.双足部出现多发性紫红色丘疹、结节和斑块2个月.组织病理检查示肿瘤位于真皮全层,瘤组织内有大量增生的血管,管腔不规则,免疫组化染色示瘤细胞CD31(+),CD34(+),Ⅷ因子相关抗原(一).诊断为血管肉瘤.     

头面部血管肉瘤1例

患者男,80岁。头面部出现簇集血疱样皮疹40d。皮损组织病理:可见不规则的血管腔,管腔由内皮细胞排列而成,内皮细胞异型性。免疫组化检查:CD31,CD34,Vimetin(+)。诊断:头面部血管肉瘤。     

经典型Kaposi肉瘤1例

报告1例经典型Kaposi肉瘤。患者男,37岁。双手足反复出现结节伴肿胀6年,脓疱2个月。皮损组织病理示:真皮及皮下组织内散在分布肿瘤细胞团块,主要由血管内皮样细胞组成,伴管腔形成;部分区域肿瘤细胞呈梭形,可见红细胞外溢及含铁血黄素沉积,散在少量单一核细胞浸润。诊断:Kaposi肉瘤。     

下肢肌周细胞瘤一例

患者,女,33岁。因右小腿皮肤丘疹30余年,伴红肿疼痛3个月。予以手术切除,术后病理示:瘤细胞以多层同心圆型围绕薄壁血管周围生长,部分可见血管管腔闭塞。免疫组化示:ERG(血管+),CD34(血管+),CD31(血管+),SMA(+),Desmin(-),H-caldesmon(+)。结合形态学及免疫组化考虑肌周细胞瘤。予以手术扩大切除后植皮。     

并发肺转移的头面部血管肉瘤

报告1例并发肺转移的头面部血管肉瘤.患者男,81岁.头面部出现多发性紫红色丘疹、结节和斑块10个月.皮损组织病理学检查:真皮梭形细胞增生,形成不规则管腔.免疫组化染色示CD31、Ⅷ因子、CD34阳性.患者近3个月出现胸闷,胸部X线及CT检查见肺内有多发性结节影.提示右肺内和左胸膜下肿瘤转移可能,最后诊断为头面部血管肉瘤并发肺转移.     

头面部血管肉瘤1例

患者男,76岁。头面部红斑2月余。皮肤组织病理示:真皮内可见形状不规则裂隙状血管腔,部分血管内皮细胞有异型性。免疫组化:CD31(+)、CD34(+)、von Willebrand因子(+)、CollagenIV血管壁(+),Ki-67阳性率8%。临床及组织病理确诊为血管肉瘤。     

微静脉性血管瘤

报告1例微静脉性血管瘤.患者男,40岁.因胸部浸润性红斑3个月就诊.皮损组织病理检查显示真皮中有许多不规则的分支状血管,管腔不明显,内皮细胞无异形.局部血管周围有少量淋巴细胞浸润.免疫组化染色结果显示血管内皮细胞CD31和CD34均阳性,而D2-40和Ki-67均阴性.符合微静脉性血管瘤的诊断.该病主要需与早期的Kaposi肉瘤鉴别.     

先天性毛细血管瘤恶变致血管内皮瘤1例

报告一例先天性毛细血管瘤恶变致血管内皮瘤。患者女，60岁，左膝关节红斑60年，结节、破溃4年。组织病理：皮肤溃疡形成，真皮及皮下血管增生明显，血管壁增厚，管腔闭塞，血管内皮细胞偶见分裂相。免疫组化染色：CD31（＋）。病理诊断：血管内皮瘤。     

头面部恶性血管内皮细胞瘤1例

报告1例老年人头面部恶性血管内皮细胞瘤。患者女，63岁。头面部无症状性红斑、丘疹3个月，伴紫红色斑块、结节11d。组织病理改变示肿瘤位于真皮浅中层，瘤组织内有大量增生的肿瘤性血管，管腔大小不一，血管内皮细胞增生，部分血管内皮瘤细胞如芏鞋钉状，瘤细胞核深染，核分裂像偶见。诊断为恶性血管内皮细胞瘤。行右颈外动脉化疗加栓塞手术治疗1次后，皮损明显好转。     

反应性血管内皮细胞增生症

报告1例反应性血管内皮细胞增生症.患者女,53岁.反复发热2年,面部出现多发性水肿性红斑2个月.超声心动图检查示主动脉瓣畸形伴赘生物形成.皮损组织病理检查示真皮乳头层和网状层有许多增生和扩张的毛细血管,内皮细胞显著增生,管腔闭塞,可见纤维蛋白性血栓.内皮细胞均无不典型性,无核分裂相.免疫组化染色结果示CD34和波形蛋白阳性,而血管内皮生长因子、CD31、FⅧ、CD45RO、CD20均阴性.     

大面积丹毒样皮肤转移癌一例

患者,女,50岁。胸背部浸润性斑块、偶有疼痛15个月。27个月前诊断为乳腺浸润性癌ⅢB期(cT4N1M0)、腋窝淋巴结转移,予化疗及右侧乳腺癌改良根治术;术后8个月右侧胸背部及左侧胸部皮肤出现红肿伴瘙痒,面积逐渐扩大。左乳皮肤病理及免疫组化示癌细胞符合乳腺癌来源。诊断：乳腺癌皮肤转移。     

老年头面部血管肉瘤1例

报告1例老年头面部血管肉瘤。患者女，70岁，头皮额部结节、包块、囊肿，伴糜烂溃疡，经久不愈3年，经5次活检和免疫组化检验确诊为老年头面部血管肉瘤，予放疗和化疗取得较好的疗效。     

An unusual case of coccidioidomycosis presenting with skin lesions

A 42-year-old white male without prior skin disease presented 8 months ago with chest pain, fever, and coughing to his primary physician. At that point, he had no skin lesions. The diagnosis was made by standard blood tests. The patient completed treatment and was symptom free for 8 months until he presented to his physician again with skin lesions on his right cheek and extremities. The patient was referred to our dermatology clinic for further evaluation. A complete skin examination revealed lesions on his face, extremities, and back. The lesions on his right face were 8 x 10-mm erythematous papules and nodules coalescing into a plaque. A biopsy was taken from his right cheek lesions.     

Angiosarcoma arising in a chronically lymphoedematous leg

Cutaneous angiosarcoma is a rare aggressive tumour of capillary and lymphatic endothelial cell origin. It presents as multiple purple and red papules and nodules on the head and neck or the extremities. We report an 86-year-old woman with angiosarcoma arising on her chronically lymphoedematous right leg. The lymphoedema, secondary to chronic immobility, had developed gradually over 40 years. No other family members had lymphoedema. The patient presented with a plaque of friable tumour tissue on the lower right leg and dorsum of the foot, and satellite lesions on the knee and groin which initially appeared to be petechial haemorrhages. The satellite lesions in the groin grew into tumour nodules. There was no evidence of a preceding malignancy, nor any operative intervention to the affected limb or abdomen. Histological examination of all tumour specimens revealed moderately to poorly differentiated angiosarcoma. She died within 5 months of the first appearance of the skin nodules.     

Spindle cell angiosarcoma following irradiation therapy for cervical carcinoma

BACKGROUND: Angiosarcomas arise in the scalp and face in the elderly, in association with chronic lymphedema (Stewart-Treves syndrome), and in irradiated areas. Rarely in these settings, angiosarcomas exhibit pure spindle cell phenotype. METHODS: Herein, the clinicopathologic features of a 72-year-old-woman with spindle cell angiosarcoma are described. RESULTS: A 72-year-old woman presented with numerous nodules and diffuse induration from the lower abdomen to the right buttock, corresponding to the area exposed to 60Co-irradiation during treatment for cervical carcinoma 10 years earlier. Histopathological examination revealed inflitrative, atypical, spindle cells that labeled with antibodies to CD31, CD34, and factor VIII-related antigen. Ultrastructurally, these malignant spindle cells contained Weibel-Palade bodies. No features suggesting radiation dermatitis (sclerosis or bizarre, large fibroblasts) were identified, but lymphangiectases and widely spaced collagen bundles(lymphedema) were prominent in the skin surrounding the angiosarcoma. Computed tomographic scan of the abdomen highlighted this histologic finding by demonstrating tumor masses limited to areas of lymphedema. Treatment with intravenous and local injections of recombinant interleukin 2 (rIL 2) followed by electron beam irradiation were initially effective with tumor remission for 2 months. However, the recurrent tumor did not respond to a second course of one-shot injection of rIL 2 through the abdominal aorta and the patient succumbed to her angiosarcoma 19 months after diagnosis. CONCLUSIONS: Radiation-induced lymphedema may be a factor in angiosarcoma associated with radiotherapy.     

老年人头面部血管肉瘤1例

报告1例老年人头面部血管肉瘤。患者男,93岁。临床表现为头皮紫红色浸润性斑块、结节1年。组织病理学检查和免疫组化染色证实为血管肉瘤。     

Koebner phenomenon on skin graft donor site in cutaneous angiosarcoma.

An 81-year-old woman developed a necrotic plaque and a surrounding purple-red, irregularly shaped macule on her scalp. The diagnosis of angiosarcoma was confirmed histologically. A wide surgical excision was made followed by a split-thickness skin graft from her right buttock. Nine months later, she noticed a dark purple-red lesion on the donor site which grew rapidly into a large mass. Histological examination revealed irregular clefts and vascular channels lined by atypical endothelial cells. Lung metastasis and pneumothorax were also noted. The secondary tumor appeared to represent Koebner phenomenon in a patient with angiosarcoma of the scalp.     

Primary mediastinal choriocarcinoma presenting as cutaneous metastasis with resistance to chemotherapy: case report and literature review

Cutaneous metastases of choriocarcinoma are rare. They may indicate poor prognosis and resistance to chemotherapy. In this report, we present a case of a 25‐year‐old man who presented with central pleuritic chest pain and right upper arm mass for about a week. The patient also had significant weight loss during the last 5 months along with an episode of generalized seizure. Chest computed tomography scan revealed an 8 cm anterior mediastinal mass. A skin punch biopsy from the right upper arm mass revealed a malignant neoplasm with morphology consistent with metastatic choriocarcinoma. Further work‐up revealed multiple lung and brain lesions. Ultrasound of the testes revealed no abnormalities. Several chemotherapy regimens were tried; however, there was no response and the disease showed progression. The patient died 6 months after initial presentation.     

Primary cutaneous anaplastic large cell lymphoma with intralymphatic involvement associated with chronic lymphedema

Chronic lymphedema predisposes to develop malignant cutaneous tumors, including angiosarcoma, Kaposi's sarcoma and B‐cell lymphoma. T‐cell malignancy has rarely been associated with chronic lymph stasis. Here, we report a case of primary cutaneous anaplastic large cell lymphoma (pcALCL) with lymphatic spread associated with chronic lymphedema. The patient is a 56‐year‐old man who received orchiectomy and right inguinal lymphadenectomy for malignant seminoma 10 years ago, which led to prominent lymphedema of the right leg. He developed extensive skin nodules on the lymphedematous area for 3 months. Histopathology findings confirmed a diagnosis of pcALCL, which is a subtype of cutaneous T‐cell lymphoma characterized by the presence of CD30+ T cells. Intralymphatic infiltration of malignant cells is prominent. The pathogenesis of intralymphatic cutaneous anaplastic large cell lymphoma is largely unknown. Our case suggests that chronic lymphedema resulted in persistent CD4+ T‐cell inflammation, which then may contribute to the development of pcALCL.     

弥漫性大B细胞淋巴瘤皮肤受累一例

患者,女,76岁,全身皮下多发结节伴右下肢皮肤溃烂2个月。皮损病理活检示（腹壁肿物）：非霍奇金淋巴结,B细胞型,免疫表型符合DLBCL,生发中心来源。免疫组化：CD20弥漫连片（+）,CD3散在（+）,CD10（+）,CD21显示FDC网消失,Ki67（80%）。胸腹部增强CT示胃窦十二指肠占位性病变,胃镜检查取胃窦部病变活检示：（胃窦小弯、大弯）非霍奇金B细胞淋巴瘤,考虑DLBCL或其他高侵袭性类型;免疫组化：粘膜腺体间弥漫的淋巴样细胞侵润性生长,CD20连片阳性,Ki67（90%）。我院血液科诊断为非霍奇金淋巴瘤（弥漫大B细胞型）IV期IPI,评分5分 继发皮肤受累。患者家属拒绝治疗,患者出院1周后死亡。