环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,45岁,双侧颈部、双手背多发淡红色及皮色扁平丘疹1个月。皮损组织病理示:表皮大致正常,真皮中上层胶原束间可见多量多核巨细胞、淋巴细胞、组织细胞浸润,并可见多核巨细胞吞噬弹性纤维碎片现象,弹力纤维染色示肉芽肿区弹力纤维减少,阿新蓝染色未见明显黏蛋白沉积。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

环状弹性纤维溶解性巨细胞肉芽肿1例

患者女,55岁。面部红色肿块8个月。皮损组织病理示:真皮下部以多核巨细胞为主的肉芽肿性浸润。特殊染色显示:真皮中下部弹力纤维减少、断裂或消失。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

额部环状弹性纤维溶解性巨细胞肉芽肿1例

患者男,58岁。额部反复出现多发性环形红斑13年余。皮损组织病理示:表皮大致正常,真皮浅层较多淋巴细胞灶性浸润,真皮内见两处肉芽肿样病变,由较多多核巨细胞和部分淋巴细胞构成,未见坏死。弹力纤维染色示:多核巨细胞内可见吞噬现象。诊断:环状弹性纤维溶解性巨细胞肉芽肿。     

合并面癣的面部光化性肉芽肿1例报道

报告1例合并面癣的面部光化性肉芽肿。患者男,73岁,面部潮红、丘疹1月余就诊。右面颊皮肤癣菌镜检（＋）。皮肤病理检查示真皮浅层组织细胞、上皮样细胞、淋巴细胞及多核巨细胞浸润,胶原日光弹力变性,抗酸染色组织细胞内有红染颗粒样物质,弹力纤维染色见弹力纤维明显减少。诊断为光化性肉芽肿合并面癣。     

环状弹性组织溶解性巨细胞肉芽肿1例

患者男,52岁,双双手背及前胸、颈部多发环形红斑2年余。颈部皮损病理组织显示:真皮中部见肉芽组织改变,其中较多组织细胞、多核巨细胞及淋巴细胞浸润,弹力纤维染色减少。诊断:环状弹性组织溶解性巨细胞肉芽肿。     

泛发型环状肉芽肿合并糖尿病1例

患者女,67岁。四肢、颈部丘疹1年,伴血糖升高。皮疹呈环状扩大,中央消退,周边隆起。皮损组织病理示:真皮内可见胶原纤维、弹力纤维变性,黏蛋白沉积,组织细胞及多核巨细胞呈栅栏状排列。诊断:泛发型环状肉芽肿合并糖尿病。     

成人泛发性环状肉芽肿1例

患者女,57岁。全身出现散在环状或半环状红色浸润性斑块1年。皮损组织病理示:真皮浅层胶原纤维变性及肉芽肿形成;弹力纤维染色示:有少量弹力纤维断裂。阿新蓝染色示:胶原束间见嗜碱性黏液性物质沉积。诊断:泛发性环状肉芽肿。     

穿通性环状肉芽肿2例

报告２例穿通性环状肉芽肿均为丘疹型，１例临床皮损类似寻常疣。组织病理示真皮上部栅状肉芽肿和穿通管道，从表皮排出真皮内变性物质。电镜观察见大量组织细胞、变性的胶原纤维和弹力纤维，坏死区组织细胞呈现变性，未见吞噬弹力纤维，但在其周围见变性弹力纤维与质膜密切接触     

环状弹性纤维溶解性巨细胞肉芽肿

报告1例环状弹性纤维溶解性巨细胞肉芽肿。患者男,59岁。躯干、四肢起红色丘疹和环状斑块4年余,加重1年。皮损组织病理检查示真皮浅中层可见散在分布较多淋巴细胞、组织细胞、上皮样细胞和局部群集的多核巨细胞浸润。阿辛蓝染色阴性。弹性纤维染色示真皮浅中层弹性纤维明显减少、缺失,部分多核巨细胞内可见吞噬的弹性纤维。结合临床、组织病理、阿辛蓝染色和弹性纤维染色,诊断为环状弹性纤维溶解性巨细胞肉芽肿。临床上,该病需与环状肉芽肿和光化性肉芽肿鉴别。     

获得性皮肤松弛症1例

患者女,25岁,口周皱纹3年,加重伴颈部皱纹1年半。皮损组织病理示:真皮浅层毛细血管周围稀疏淋巴细胞浸润;弹力纤维染色示真皮全层弹力纤维基本消失,局部见少数断裂的弹力纤维碎片。诊断:获得性皮肤松弛症。     

Papular elastolytic giant cell granuloma: a clinical variant of annular elastolytic giant cell granuloma or generalized granuloma annulare?

A 71-year-old man with asymptomatic red papules on the trunk and upper arms was reported as a case of papular elastolytic giant cell granuloma. A skin biopsy specimen from a papule on the back showed similar findings to those of annular elastolytic giant cell granuloma. However, centrifugal annular lesions were not clinically observed. He was successfully treated with tranilast and topical steroids.     

Expression of 67-kDa elastin receptor in annular elastolytic giant cell granuloma: elastin peptides induce monocyte-derived dendritic cells or macrophages to form granuloma in vitro

Annular elastolytic giant cell granuloma (AEGCG) is characterized by non-palisading granuloma and elastophagocytic giant cells. Granulomas consist of structured masses of macrophages, dendritic cells, and T lymphocytes which play an essential role in granuloma formation. Two lineage systems of dendritic cells and macrophages originated from peripheral blood monocytes have been established in vitro. To know how elastin fragments are involved in the granuloma formation in AEGCG, we tested in vitro whether elastin fragments potentially induce monocyte-derived macrophages or dendritic cells to form granuloma and multinucleated giant cells. Immunohistochemical studies of the lesional skins of AEGCG (n = 5) revealed that the 67-kDa elastin receptor was specifically expressed in the epithelioid or multinucleated giant cells. Proliferation of factor XIIIa(+) cells and CD68(+) cells was also seen in the lesional skins of AEGCG. Factor XIIIa(+) dendritic cells or CD68(+) macrophages were established by the treatment of granulocyte/macrophage-colony stimulating factor (GM-CSF)/interleukin-4 or M-CSF, respectively. Further treatments of these dendritic cells or macrophages with elastin peptide resulted in the formation of granuloma or multinucleated giant cells which were immunoreactive with anti-67-kDa elastin receptor antibody. These findings suggest that elastic tissue induces factor XIIIa(+) cells and CD68(+) macrophages to form granuloma or multinucleated giant cells and plays an essential role in the formation of granuloma in AEGCG.     

Giant recurrent pyogenic granuloma on the face with satellitosis responsive to systemic steroids

Pyogenic granuloma is a common benign skin tumour. However, giant recurrent pyogenic granuloma with satellitosis is relatively rare. We present a 52-year-old man who had recurrent gigantic pyogenic granuloma with satellitosis responsive to systemic steroids. Our case of recurrent pyogenic granuloma is interesting because of its clinical presentation, recurrence following surgical excision and its steroid responsiveness. Systemic steroids may be effective in treating recurrent giant pyogenic granulomas during their high-proliferation phase.     

Generalized elastophagocytic granuloma.

The case of an eighty-three-year-old woman with the sudden onset of a generalized pruritic eruption is reported. The skin lesions resembled disseminated subacute lupus erythematosus on clinical examination, but actinic granuloma or annular elastolytic giant cell granuloma was seen in biopsy specimens of the lesions. Our case was differentiated from generalized granuloma annulare by the distinct zoning of elastolysis and the distribution of giant cells.     

泛发型环状肉芽肿2例

环状肉芽肿是以环状丘疹或结节性损害为特征的慢性皮肤病,其中泛发型环状肉芽肿临床较少见。本文报道2例女性泛发型环状肉芽肿病例,皮损表现为躯干四肢弥漫的丘疹、环状斑块。甲状腺功能、EB病毒及巨细胞病毒抗体、血糖血脂检查均未见异常。组织病理表现为真皮浅中层栅栏样肉芽肿形成,中央结缔组织变性,周围上皮样细胞,多核巨细胞及淋巴组织细胞浸润。     

Histopathology of necrobiotic xanthogranuloma with paraproteinemia

Fifty-three cutaneous biopsies from 22 patients with necrobiotic xanthogranuloma (NXG) were reviewed. One or more biopsies from each patient displayed a typical pattern of palisading histiocytic xanthogranuloma with bands of hyaline necrobiosis. Multiple foam cells and Touton giant cells were present, and atypical, bizarre-appearing foreign body giant cells were characteristic. Cholesterol clefts were found in 18 specimens, and lymphoid nodules were found in 24, 8 of which had germinal center formation. Twenty-one specimens contained foci of plasma cells, and these were located perivascularly, at the periphery of lymphoid nodules, and, as infiltrates, between dermal collagen bundles. Unique features were xanthogranulomatous panniculitis, often appearing as Touton cell panniculitis, and a rare but distinctive palisading cholesterol cleft granuloma. The cytoplasm of giant cells and histiocytes contained PAS-positive, diastase-resistant polysaccharide. Examination of 3 cases by electron microscopy revealed dendritic cells in the epidermis and vacuolated dermal histiocytes. S-100 antibody was negative in 3 cases. Leukocyte monoclonal antibody studies in 6 patients showed predominantly T-helper lymphocytes within the granuloma. NXG is a T-helper cell, non-X histiocytic granuloma with a distinctive histopathology.     

环状弹性组织溶解性巨细胞肉芽肿1例

患者男,50岁。双手背部及颈部多发环形红斑2年余。颈部皮损组织病理示:真皮浅层见较多的多核巨细胞浸润,可见吞噬,特殊染色显示弹性纤维碎裂和吞噬。诊断:环状弹性组织溶解性巨细胞肉芽肿。予中药活血散结治疗,症状较前好转。     

Solitary reticulohistiocytic granuloma--a report of three cases and a review of literature

Case 1 was a 20-year-old male with a nodule on the scrotum. Case 2 was a 14-year-old female with a dome-shaped, reddish-brown nodule on the nose. Case 3 was a 30-year-old male with a dome-shaped, reddish-brown nodule on the forearm. All of the excised specimens showed typical features of solitary reticulohistiocytic granuloma. There were histiocytes and multi-nucleated giant cells in the dermal tumorous nests. They were stained positively with PAS reaction and anti-lysozyme antibody, but were stained negatively with S-100 protein antibody. To clarify the nosology of the reticulohistiocytic granuloma, we reviewed the literatures of multicentric reticulohistiocytosis and adult xanthogranuloma. Multicentric reticulohistiocytosis was considered to be a systemic disease and different from solitary reticulohistiocytic granuloma. However, adult xanthogranuloma showed clinical similarities to solitary reticulohistiocytic granuloma instead of the differences in the histopathologic features.     

无汗性外胚叶发育不良伴巨大型环状肉芽肿1例

报告1例无汗性外胚叶发育不良伴巨人型环状肉芽肿,患儿男,8岁,出生后从未出过汗,头部,面部,躯干,四肢散在直径2～20cm淡红色环状斑块1年,体格检查可见头发稀疏,鞍状鼻,臼状门齿,锥状尖牙,组织病理诊断,环状肉芽肿。     

Generalized granuloma annulare with primary biliary cirrhosis

Fifty-six year-old woman had a wide spread nodular and papular eruption on the trunk and arms for one week. She had suffered from primary biliary cirrhosis (PBC) for 8 years. The clinical appearance of the eruption was that of generalized granuloma annulare. Skin biopsy revealed a palisading granuloma in the dermis consisting of suppressor/cytotoxic T cells, Langhans type giant cells, plasmacytoid epithelioid cells and phagocytic macrophages with immunohistochemical analysis and electron microscopy. Liver biopsy showed Scheuer's IIIrd stage of PBC without associated granuloma. In PBC granulomata at the portal area of the liver, lung, muscle, skin and so on has been reported. And the histological findings of the granuloma of this case consisted with that of reported cases. Therefore the skin granuloma in this case was assumed to be related to PBC.