436例色素痣样病变临床及病理分析

目的：探讨色素痣样病变临床和病理之间的关系,为评估病情提供线索。方法：对436例色素痣样病变的临床表现及病理特征作回顾性分析。结果：所有临床上表现为色素痣样病变的病例中,病理确诊为色素痣共有329例（75％）,其中皮内痣、混合痣、交界痣比例分别为60．09％、11．92％和3．44％;脂溢性角化病范围表皮囊肿等的比较较少。结论：正确诊断色素痣样病变,需要临床病理相结合,建议在临床中色素痣样病变如需手术切除时切口宜加深扩大,常规送病理检查,并注意随访。     

痣样黑素瘤三例临床及组织病理学分析

【摘要】 目的 探讨痣样黑素瘤的临床和组织病理学特征。方法 回顾性分析2000—2020年西京皮肤医院诊断的3例痣样黑素瘤患者的临床和组织病理资料。结果 3例痣样黑素瘤患者中,女2例,男1例,皮损初始表现为黑斑、丘疹。2例在手术切除后皮疹复发增大成斑块或新发结节样皮损。组织病理学检查：表皮及真皮内上皮样黑素细胞增生,细胞有异型性,部分细胞核深染。免疫组化结果显示,皮损内瘤细胞Melan-A、S100表达阳性;HMB45在真皮瘤细胞内弥漫阳性,局部阴性;Ki67增殖指数升高,细胞周期蛋白D1表达活跃。结论 痣样黑素瘤易误诊为色素痣或脂溢性角化病;对于组织学诊断为色素痣,但临床出现复发或者转移的患者,需高度警惕痣样黑素瘤的可能。     

晕痣

晕痣以色素痣绕以圆形或椭圆形局限性色素减退为特征，中心痣大多是后天性痣细胞痣。CD8＆＋为主的T细胞清除痣细胞是发病机制中的关键环节。晕痣与白癜风、黑素瘤在抗原及免疫反应模式方面密切相关。尽管目前认为，对晕痣患者进行随访是最好的治疗策略，但手术切除有助于平息晕痣的免疫活动，因此对于单发皮损，手术切除也许更为合适。     

Meyerson痣6例临床及病理分析

目的:探讨Meyerson痣临床及组织病理特征。方法:回顾性分析2015年1月至2020年1月第四军医大学西京皮肤医院确诊的6例Meyerson痣患者临床及病理资料。结果:6例患者中,男3例,女3例,年龄7个月至28岁,中位年龄10.5岁。3例皮损位于四肢,3例位于躯干。4例发生于先天性色素痣,2例发生于获得性色素痣。...     

125例不同部位色素痣样皮损临床病理特征及误诊原因分析

目的 比较不同部位的125例色素痣样皮损的临床诊断与病理诊断的符合率,分析临床误诊的原因,提高皮肤科医生对色素痣的认识.方法 回顾性分析某医院门诊2019年1月至12月临床诊断为色素痣且均行手术切除及病理检查的125例患者的临床及病理资料.分析不同年龄和性别中各种色素痣样皮损的分布情况.结果 125例患者中,病理诊断为...     

先天性巨色素痣6例

目的　探讨先天性巨色素痣的发病机制。方法　对 6例先天性巨色素痣的临床资料及组织病理、免疫组化结果进行分析。结果　6例平均年龄 28岁, 5例出生时即发病。临床诊断恶性黑素瘤 2例,黑痣恶变、先天性巨色素痣、软组织纤维瘤、皮肤色素沉着各 1例。组织病理诊断皮内痣 4例,复合痣 2例。结论　先天性巨色素痣发病符合双重来源学说,即真皮上部的痣细胞来自表皮的黑素细胞,而真皮下部的痣细胞来自神经鞘细胞。减少并发症的关键在于早诊断、早治疗。     

先天性色素痣伴增生性结节10例临床病理分析

【摘要】 目的 探讨先天性色素痣伴增生性结节的临床特点及组织病理特征。方法 收集第四军医大学西京皮肤医院2015—2019年经临床和病理确诊的10例先天性色素痣伴增生性结节患者的临床及病理资料，并进行回顾性分析。结果 10例患者年龄2～45岁（平均15岁），9例增生性结节发生于婴儿，1例发生于成人。皮损位于四肢4例，头面部3例，躯干2例，躯干及四肢同时受累1例。临床表现为黑色斑片或斑块中出现1个或多个结节，6例增生性结节为多发，4例为单发，单个结节直径0.2～1.5 cm，仅1例出现溃疡。组织病理检查显示增生性结节内黑素细胞均存在成熟现象，核分裂象少，细胞无明显异型性，无坏死现象，免疫组化检查显示痣细胞弥漫表达Melan-A，不表达或仅部分表达HMB45，Ki67增殖指数 < 5%。结论 先天性色素痣伴增生性结节可发生于四肢、头面部及躯干；临床表现为原先天性色素痣皮损上的单发或多发结节；病理上增生性结节内黑素细胞可见成熟现象，免疫组化HMB45及Ki67染色有助于诊断，其预后有待长期随访。     

15例甲下色素痣临床及组织病理学分析

目的:探讨甲下色素痣的临床及组织病理学特点.方法:回顾分析西京医院全军皮肤病研究所2003-2009年诊断的15例甲下色素痣患者的临床及组织病理学特点.结果:15例患者年龄均<25岁,其中男6例.女9例.发生于指甲14例,发生于趾甲1例,各指(趾)间病甲分布无明显差异.12例表现为界限清楚,颜色均一的甲黑线,3例表现为全甲黑变.有1例患者为复发性甲色素痣.组织病理资料显示14例患者表现为交界痣,1例为混合痣,未发现单纯皮内痣患者.甲色素痣表现为以甲母质为中心的黑素细胞增生,细胞呈单个分布或聚集成巢,多位于近基底层部位.混合痣真皮内可见少量界限清楚的细胞巢.色素痣细胞形态均一,细胞核小,无典型核分裂象,树状突不明显,多产生较细腻的色素颗粒.结论:甲下色素痣是发生在甲母质及甲板部位的良性色素痣,多见于儿童和青少年,临床以颜色均一、界限清楚的甲黑线或弥漫性黑甲为主要表现.其组织病理特征多为交界痣.     

面部色素痣手术治疗300例临床分析

目的:分析对面部色素痣进行微创切除或皮瓣移植术的方法、安全性及疗效.方法:对300例面部色素痣进行微创手术切除,较大及特殊部位的色素痣行皮瓣移植术,无损伤缝线减张缝合.结果:300例面部色素痣患者术后无1例复发,并且均达到美容效果;其中1例感染,2例经组织病理检查为基底细胞癌.结论:微创切除或皮瓣移植术治疗面部色素痣具有一次性彻底根除不复发,皮损可行组织病理活检而更安全,基本无瘢痕,重要部位不变形,达到美容等多重目的,是目前治疗面部色素痣最理想的方法.     

先天性色素痣术后诱发白癜风及多发性晕痣一例

先天性色痣（Congenital Pigmented Nevus）是一种特殊类型的痣细胞痣,约有10%的恶变倾向[1]。临床上为预防恶性变,常切除巨大色素痣。现将1例患者先天性色痣切除后诱发白癜风及多发性晕痣报告如下。     

White sponge nevus. Seven cases in the same family

Seven cases of white sponge nevus in seven women of the same family are reported. At birth the patients had lesions consisting of asymptomatic white spongy plaques located on the oral mucosa; in two patients the lesions also involved the vaginal mucosa. The lesions improved after antibiotic treatment. Histology was performed in four cases and an ultrastructural study in one. The findings were consistent with the diagnosis of white sponge nevus in all cases. Differential diagnosis was made with other conditions presenting as white lesions of the oral mucosa.     

White sponge nevus: A condition not always clinically suspected

White sponge nevus (WSN) is an uncommon benign inherited disorder characterized by white and diffuse painless lesions in oral, esophageal, or genital mucosa. The lesions may develop at birth or later in childhood or adolescence, with careful clinical examination being sufficient for diagnosis in most cases. However, microscopic analysis may be necessary particularly in adults in which other whitish oral lesions may be clinically suspected. Dermatologists, dentists, and pathologists should consider WSN when evaluating multiple white oral lesions, thus preventing unnecessary treatments. Herein, we report four additional cases of WSN with emphasis on its clinical and histopathological features.     

Plaque-type blue nevus of the oral cavity

BACKGROUND: The blue nevus of the oral cavity is a rare lesion with important differential diagnoses. The plaque-type blue nevus is an uncommon variant of the blue nevus. Because of its particular clinical appearance, it can easily be confused with satellite metastases from malignant melanoma. The diagnosis usually requires a biopsy. OBJECTIVES: To describe the clinical and histological features of a plaque-type blue nevus of the buccal mucosa in a 20-year-old white woman, to review all intraoral blue nevi and all plaque-type blue nevi reported in the literature so far and to compare the criteria of blue nevi and nevus of Ota. RESULTS: An intraoral blue nevus was described for the first time in 1959. Since then around 70 further cases have been documented. Our case is the first report of a plaque-type blue nevus of the oral cavity. CONCLUSIONS: The exceptional widespread intraoral blue nevus described herein can clinically be confused with an intraoral malignant melanoma, and it has a very similar clinical appearance as the intraoral part of nevus of Ota. Apart from the clinical resemblance, there is also some degree of histological overlap of the dermal melanocytoses. Transitional states between blue nevus and nevus of Ota may occur clinically and histologically.     

Intraoral cellular blue nevus: report of a unique histopathologic entity and review of the literature

The blue nevus is found most frequently on the skin; however, in rare instances, it has been reported on oral mucous membranes. Intramucosal nevi make up more than one half of all reported intraoral melanocytic nevi. The common blue nevus is the second most common variant. Among the 3 variants of blue nevi, the cellular variant occurs less frequently than the common and combined variants. We present a rare case of intraoral cellular blue nevus that occurred on the oral mucosa of the hard palate. Because of the clinical and microscopic resemblance of the cellular blue nevus to melanoma and the rarity of this lesion in the oral cavity, recognition and accurate diagnosis are critical.     

浅表脂肪瘤样痣6例临床及病理分析

目的：介绍不同部位、不同发病年龄的浅表脂肪瘤样痣患者的临床及病理学特点。方法：回顾6例患者的病史及临床、病理资料。结果：经病理学证实6例患者均为多发型浅表脂肪瘤样痣。手术切除皮损后，均取得了满意的效果。结论：多发型浅表脂肪瘤样痣可发生在30岁之前，臀部、骨盆及其他部位，躯体的单侧或双侧；有时皮损可合并有皮下肿块。     

Leukoplakia-like epidermal nevus of the mouth mucosa. Case report

We report on a nevus of the oral mucosa, which became present in the age of 30 of a male patient. By microscopic examination we did not find any vacuolation of the spinous layer of the epithelium. So this nevus has been considered quite different from the typical white sponge nevus, and we prefer to name it leucoplakial nevus of the oral mucosa.     

Spindle cell lipoma of the oral cavity

Spindle cell lipoma is typically seen in the neck/trunk region of middle-aged and older men. Rare cases of oral spindle cell lipoma have been reported. An entity described as myxoid lipoma of the oral cavity has rarely been reported but appears to be more properly classified as spindle cell lipoma. We describe the largest series yet of oral spindle cell lipoma involving the tongue (4), buccal mucosa (1), floor of mouth (1), and lip (1). The patients (3M; 4F) ranged from 31 to 88 years old. All presented with mass lesions. All were circumscribed and composed of mature adipocytes admixed with bland spindled cells. In two cases the adipocytes appeared atrophic, imparting a pseudo-lipoblastic appearance. No true lipoblasts were seen and none had the characteristic vasculature of a myxoid liposarcoma or the characteristic hyperchromatic cells of well-differentiated liposarcoma. The stromal background of all cases contained characteristic wiry collagen and myxoid ground substance. The myxoid ground substance was prominent in four cases. Immunohistochemical stains for CD34 highlighted the bland spindle cells in all cases. The combination of the histologic features and the immunoreactivity for CD34 confirmed the diagnosis. Spindle cell lipoma should be considered in the differential diagnosis of oral cavity mesenchymal tumors.     

罕见口腔黏膜皮内痣1例

报告1例口腔黏膜皮内痣。患者男,15岁。口腔黏膜肿物15年,近3个月来肿物增长较快。皮损组织病理示:真皮内可见大量呈巢状痣细胞,其内见较多黑素颗粒,细胞成熟未见核分裂相。诊断:口腔黏膜皮内痣。行右下前牙拔除+肿物切除+局部牙槽骨去除术,并予抗感染治疗,创面愈合良好,无复发。     

White nevus of the oral mucosa]

A white sponge nevus of the oral mucosa is described in a 12-year-old girl and her 36-year-old mother. This anomaly, which is inherited as an autosomal dominant trait, deserves no treatment. Because of the bilateral involvement, which is found in the majority of cases, the white sponge nevus is often misdiagnosed as therapy-resistant thrush.     

White sponge nevus: clinical suspicion and diagnosis

White sponge nevus is a rare, autosomal-dominant disorder that affects the noncornified stratified squamous epithelia. Clinically, the presence of white, spongy plaques mostly in the buccal, labial, and gingival mucosa and the floor of the mouth characterize the lesions. The differential diagnosis of the lesion may be difficult and it is best diagnosed by biopsy. We report a case of white sponge nevus in the oral cavity of a 16-year-old boy and review of the literature.