透明细胞汗管瘤1例

患者女,71岁。下眼睑多处肤色1~5mm丘疹5年。皮损组织病理示:真皮内由透明细胞组成的条索状上皮样肿瘤团块,中央形成管腔,部分呈蝌蚪状分布。CEA,PAS染色管腔及管内容物阳性。诊断:透明细胞汗管瘤。     

黏液性皮肤纤维瘤

报告1例黏液性皮肤纤维瘤.患者女,43岁.右前臂丘疹2周余.皮肤科检查:右前臂一直径约0.8 cm结节.组织病理检查示表皮不规则增生,真皮内可见大量梭形细胞增生,局部胶原排列疏松,阿新蓝染色阳性.免疫组化染色结果示波形蛋白(vimentin)阳性,CD31、CD34、平滑肌肌动蛋白(SMA)和S-100蛋白阴性.诊断为黏液性皮肤纤维瘤.     

下颌肤色结节——软骨样汗管瘤

诊断:软骨样汗管瘤. 皮损组织病理检查:皮下组织中限局性肿瘤,嗜碱性的结节性基质中,可见上皮细胞构成的不规则囊腔和管腔.囊壁由二三层复层立方上皮构成,囊腔内见丰富的嗜碱性黏液样和假软骨性基质.免疫组化组织病理:管腔内外层细胞低分子质量角蛋白(CK)阳性,管腔内层细胞上皮细胞膜抗原(EMA)阳性、癌胚抗原(CEA)阳性.     

汗管样小汗腺癌国内首报

患者女,56岁。右口角斑块2年余。皮肤科情况:右口角见一2.2cm×1.4cm浸润性肤色斑块,中央偏淡红色,表面不平,边界清楚,与皮肤黏连,质硬。组织病理检查示:真皮中下部及皮下组织见多数基底样瘤细胞团块,瘤细胞形成巢状、条索状或蝌蚪样肿瘤团块,伴有大量管腔及囊腔样结构形成,部分腔内可见嗜酸性均一物质。间质明显增生,可见透明变性和黏液变性。未见角质囊肿及筛状结构形成。免疫组化染色示:肿瘤细胞上皮膜蛋白(EMA)和癌胚抗原(CEA)阳性,S100蛋白、角蛋白10(CK10)、角蛋白20(CK20)和GCDFP-15(gross cystic disease fluid protein-15)均阴性。诊断:汗管样小汗腺癌。本病临床罕见。治疗采用Mohs手术切除。     

局限于双腋下的斑块状汗管瘤1例

患者女,22岁。双腋下褐色丘疹融合成斑块3年余,皮损组织病理学检查示:真皮内见囊性管腔及嗜碱性细胞条索,部分呈蝌蚪样改变,管壁为双层上皮,管内见嗜伊红无定形物质。诊断:斑块状汗管瘤。     

国内首例慢性播散性副球孢子菌病

报道国内首例慢性播散性副球孢子菌病。患者男, 49岁, 因皮肤丘疹、结节1年, 口腔黏膜丘疹、溃疡2个月入院。皮肤科检查:左足水肿, 左足底多发溃疡, 表面结痂, 左足第3、4趾间及第4、5趾间溃疡, 基底呈颗粒状, 伴点状出血、渗出;左足背、左足内侧及左膝多发丘疹、结节、斑块, 中央溃疡、结痂;左腕部2个丘疹, 上唇左侧1个丘疹, 表面结痂;牙龈、颊黏膜、唇黏膜及上颚可见红色斑块伴溃疡、点状出血, 皮损以左侧为主。浅表淋巴结彩超:双侧颈部及锁骨上窝淋巴结肿大, 左侧为著。胸腹部计算机断层扫描图像示:双肺弥漫粟粒样结节影及条索状、云絮状、结节状高密度影, 左侧肾上腺明显增粗。口腔、左下肢皮损组织真菌免疫荧光染色, 可见酵母细胞。口腔黏膜、左下肢皮损组织病理:肉芽肿性炎, 多核巨细胞内外可见酵母细胞, 折射双膜, 无芽、单芽或多芽;过碘酸希夫染色、六胺银染色阳性。左下肢皮损组织真菌培养:25 ℃、37 ℃沙氏葡萄糖琼脂培养基中培养阳性, 均为菌丝相。口腔黏膜及肺泡灌洗液宏基因组学测序:巴西副球孢子菌。诊断:慢性播散性副球孢子菌病。予伊曲康唑胶囊400 mg/d口服, 1个月后皮肤、黏膜皮...     

左颊部黏液表皮样癌

报告1例左颊部黏液表皮样癌。患者女,80岁。左颊部肿块半年。体格检查:左颊部见一约3.0 mm×2.5 mm黑褐色圆形实性肿块,呈分叶状。组织病理示真皮内见肿瘤细胞团块,瘤细胞较大,有异形性,瘤巢周围散在淋巴细胞浸润。免疫组化示肿瘤细胞细胞角蛋白(CK)、P63阳性,上皮膜抗原(EMA)少量细胞阳性,癌胚抗原(CEA)、肌动蛋白(actin)阴性,Ki-6710%(+),AB-PAS染色肿瘤局部可见少量黏液,结合组织病理和免疫组化诊断为黏液表皮样癌。     

丛状血管瘤1例

患儿女,2月,左腰背部斑块伴疼痛1月。皮肤科检查可见左腰背部一9.0cm×4.0cm大紫红色斑块,中央隆起,质稍硬,触之有结节感和浸润感。组织病理检查示真皮内散在毛细血管组成的团块,呈丛状或卵圆形。可见圆形或不规则形管腔,含有较多的内皮细胞,细胞核呈卵圆形或梭形,内皮细胞可形成血管裂隙或不规则管腔,细胞无异形性。免疫组化染色示内皮细胞CD34和CD31(+),周皮细胞平滑肌肌动蛋白(SMA)表达阳性。     

复发性浅表性肢端纤维黏液瘤1例

报告1例浅表性肢端纤维黏液瘤。患者男,49岁。左手中指结节半年。皮肤科检查:左手中指末端指指关节掌侧一约绿豆大淡红色结节,表面较光滑,触之偶有疼痛。皮损组织病理检查:真皮内见结节状梭形细胞及星状细胞增生,间质疏松、水肿,可见肥大细胞,阿辛蓝染色阳性。免疫组化示:波形蛋白(vimentin)阳性,上皮膜抗原(EMA)及CD34局灶阳性。诊断为浅表性肢端纤维黏液瘤。     

黏液性隆突性皮肤纤维肉瘤

报告1例黏液性隆突性皮肤纤维肉瘤.患者男,64岁.左下肢膝关节部位出现肿块30年.皮肤科检查:左侧膝关节部佗可见一直径约10 cm大肿块,表面有大小不一的结节,并有糜烂和溃疡.肿块边界不规则,向周围正常组织浸润.皮损组织病理检查:真皮内弥漫性梭形细胞增生,细胞间隙明显增大.阿新蓝染色示大量黏蛋白沉积;免疫组化染色结果示CD34阳性.诊断:黏液性隆突性皮肤纤维肉瘤.     

Combined Mastocytoma-hemangioma in a Patient with Urticaria Pigmentosa

A patient with long-standing urticaria pigmentosa presented with a pea-sized reddish to purplish papule on the posterior part of the right ear. Histopathologic examination revealed numerous dilated vascular structures in the upper dermis and mast cell infiltrations throughout the whole dermis, consistent with combined mastocytoma-hemangioma. The mast cells were strongly positive with Giemsa stain.     

Folliculosebaceous cystic hamartoma arising within a port-wine stain

A 34-year-old woman presented with 2-year history of a dome-shaped papule on a well-circumscribed, thickened, port-wine stain on the left side of the chin. Squeezing on the port-wine-stain plaque revealed many comedos within dilated follicular orifices. The papule was excised and submitted for histological examination. Histopathological study showed a lobular neoplasm, comprising dilated, cystic pilosebaceous structures surrounded by fibrous stroma, bearing the characteristics of folliculosebaceous cystic hamartoma. The reported case shows that, in addition to the vascular nature, both ectodermal and mesenchymal abnormalities may be involved in port-wine stains.     

成人型黄色肉芽肿1例

 报告成人型黄色肉芽肿1例。 患者男,27岁,左上肢黄色丘疹2年。皮肤科检查：左上肢见直径约3 mm淡黄色半球形丘疹,表面光滑。皮肤镜检查见橘黄色云状无结构区域。共聚焦显微镜检查：表皮轻度萎缩,皮损境界清楚,真皮内见大量周边高折光的盘状结构以及大量点状高亮结构。皮损组织病理检查：表皮轻度萎缩,真皮内见境界清楚的细胞团块,主要由组织细胞及少量炎细胞组成,组织细胞泡沫化,可见Touton巨细胞。免疫组化：CD68（+）,CD163（+）,S100（-）,CD1a（-）。诊断为成人型黄色肉芽肿。外科手术切除后随访6个月,未见复发。     

皮肤镜辅助诊断小汗腺汗孔瘤1例

报告1例小汗腺汗孔瘤.患者男,58岁.左足跟部红色肿物10余年.皮肤科检查:左足跟腱部可见直径约1 cm的红黑色隆起性结节,质软,边界清楚,伴外周褐黑色色素沉着.皮肤镜下可见边界清晰的类圆形结节,皮损中央可见多个叶状血管,血管周围有白色晕.皮损组织病理检查:真皮内可见与表皮相连的肿瘤细胞团块,向下延展进入真皮,瘤细胞大...     

CD34-reactive myxoid dermal dendrocytoma.

Normal skin is composed in part of cells that express CD34. These include periadnexal spindle cells, vascular endothelial cells, and interstitial dendritic cells. We report on a tumor composed mainly of CD34-reactive spindle cells. A 66-year-old Japanese woman presented with a skin-colored, dome-shaped, cutaneous papule on her left palm that was 7 mm in diameter and had developed within the preceding 3 months. Light microscopic examination showed a well-circumscribed polypoid tumor consisting of spindle-shaped cells and thin collagen fibers arranged loosely in a fascicular pattern within a myxoid matrix. Immunohistochemically, most of the tumor cells stained strongly for CD34, but did not stain with antibodies to S-100 protein, smooth muscle actin, desmin, neuron-specific enolase, epithelial membrane antigen, or factor XIIIa. Staining for vimentin and CD68 was positive. We believe this lesion to be a CD34-reactive myxoid dermal dendrocytoma of a type that has not been described previously.     

儿童肢端假性淋巴瘤样血管角皮瘤一例临床病理特征

【摘要】 患儿女，13岁，右足部皮疹伴瘙痒5年。皮肤科检查：右足弓内侧散在紫红色扁平丘疹，表面轻微鳞屑，右拇趾外侧散在淡红色丘疹，右足跟散在圆顶紫红色丘疹，基底外周领圈状角化。右足跟丘疹组织病理学检查：表皮角化过度，两侧显著角化过度，颗粒层增厚，棘层无明显增生，基底层局灶液化变性，真皮层大量淋巴细胞、浆细胞增生浸润，无异形性，其中可见较多的中小厚壁血管，管腔扩张，内衬突出饱满的内皮细胞。诊断：儿童肢端假性淋巴瘤样血管角皮瘤。治疗：Nd:YAG长脉宽1 064 nm激光每月治疗1次，治疗7次后，皮疹较前消退，数目减少。     

基底细胞样毛囊错构瘤1例

患儿男,5岁。左上臂外侧泛发棕色丘疹3年。皮肤科情况:左上臂外侧不规则分布棕色丘疹,中等硬度。皮损组织病理示:真皮内基底样小细胞呈条索状交互吻合,嵌于疏松的纤维性基质内,团块细胞周边呈明显的栅栏状。诊断:基底细胞样毛囊错构瘤。     

Apocrine hidradenocarcinoma showing Paget's disease and mucinous metaplasia

A 54-year-old man presented with a solitary, erythematous, rapidly growing 1-cm nodule on his scalp that had arisen over the previous 3 months. He had no history of skin cancer. An excisional biopsy of the lesion showed a fairly well-circumscribed but focally invasive tumor consisting of areas of typical-appearing clear cell hidradenoma as well as areas with mucinous goblet-type cells and cells with eosinophilic cytoplasm and decapitation-type secretion. There was marked cellular atypia, numerous atypical mitotic figures and focal necrosis. The tumor cells focally involved the overlying epidermis (Paget's disease). Large areas of mucin were identified throughout the lesion. The tumor cells stained with markers for cytokeratin 7 and focally for EMA and CEA, confirming ductal differentiation. The goblet cells and mucinous areas stained with mucicarmine and PASD. The patient was diagnosed with hidradenocarcinoma with mucinous differentiation. Associated Paget's disease has only rarely been reported, and mucinous metaplasia is a previously unreported feature in hidradenocarcinoma.     

Clear cell fibrous papule with NKI/C3 expression: clinical and histologic features in six cases

Fibrous papule of the nose is a common benign lesion of dermal fibroblast lineage. Two unusual variants have been described, namely, fibrous papule with granular cells and fibrous papule with clear fibrocytes. We report a second case series (six cases) of clear cell fibrous papule to add to the first series of 9 cases. Clinical and histologic features in our cases are similar to those in the first series. All of our specimens were dome-shaped, 2- to 5-mm skin-colored to slightly erythematous papules on the faces of three male and three female adults ranging from 18 to 48 years of age. All but one lesion were on the nose. Clinical differential diagnoses included fibrous papule, verruca, basal cell carcinoma, and a variety of other neoplasms. Histologically, dermal aggregates of clear cells with finely granular to vacuolated cytoplasm, and centrally located nuclei, were found. Most specimens also contained ectatic capillaries, and all showed evidence of irritation or trauma. Periodic acid-Schiff stain was negative in all specimens to which it was applied (5/6). Neural, melanocytic, and epithelial origins were eliminated by negative staining with S-100, Mart-1, cytokeratins, epithelial membrane antigen, and carcinoembryonic antigen, performed on some of the specimens. A mesenchymal nature was confirmed in one specimen staining strongly positive for vimentin. Five of six cases stained positively for CD68, and all five cases studied were strongly and diffusely positive for NKI/C3. Factor XIIIa stain highlighted scattered dendritic cells within the lesion but was otherwise negative in all six cases studied. Recognition of this variant of fibrous papule is important to distinguish this benign lesion from other clear cell neoplasms.