150例皮肤纤维瘤组织病理与临床分析

目的 分析皮肤纤维瘤（DF）的组织病理与临床特征,探讨两者的相互联系。方法 回顾分析2017年9月至2018年8月在上海市皮肤病医院病理科经皮肤组织病理检查确诊的150例DF患者的临床和组织病理资料。结果 150例患者中,男65例,女85例,年龄（42 ± 13.8）岁,病程3个月至 > 30年,部分有伴随症状,主要表现为瘙痒,有自发痛、轻压痛,18例皮损有外伤、虫咬或感染病史。皮损主要位于四肢（107例,71.3%）,以单发皮损为主（105例,70%）。病理检查前拟诊为“DF”102例,“表皮样囊肿”16例,“色痣”13例,“瘢痕疙瘩”3例,“皮肤肿物”12例,“恶性黑素瘤”1例,“黄色肉芽肿”1例,“结节性痒疹”1例,“神经纤维瘤”1例。在这些患者的169张苏木精-伊红染色切片中,66张（39.1%）为细胞性,36张（21.3%）硬化性,25张（14.8%）表现为动脉瘤样型DF,22张（13.0%）上皮样型。12张切片内可见两种或两种以上亚型并存的现象。还可见少数新的变异型,如DF伴汗腺导管增生（1例）、深在型DF（3例）、上皮样细胞与增生胶原相间的DF（1例）等。动脉瘤样型DF病程长短不一,7个月至> 30年,多表现为发生于下肢的皮肤肿物样损害。细胞性DF病程相对较短,常发现数月后就诊,好发于四肢,常伴痒痛。硬化性或萎缩性DF病程长,为数年或数十年,好发于上肢,多无伴随症状。上皮样型DF病程长短不一,临床表现多样,多发于下肢,无伴随症状。结论 DF的临床表现及病理表现均具有多样性,不同的DF皮损可有相似的典型组织病理学表现,不典型的病理表现可干扰疾病诊断。     

动脉瘤样纤维组织细胞瘤一例

患者,女,71岁。左胫前黑褐色结节5年。结合临床症状和组织病理检查,诊断为动脉瘤样纤维组织细胞瘤。给予手术完整切除治疗,随访至今未复发。     

动脉瘤样纤维组织细胞瘤1例

患者女,42岁。背部出现结节1年,伴瘙痒。皮肤科情况:背部可见一个豌豆大蓝褐色结节,皮损组织病理示纤维组织细胞瘤结构中出现出血性腔隙。手术切除结节,随访至今无复发。     

动脉瘤样纤维组织细胞瘤1例

<正>1病历摘要患者女,62岁。左上臂暗红色结节2年余。患者2年前无明显诱因左上臂出现暗红色结节,有痒痛感,逐渐增大,未行特殊处理,近期逐渐增大,伴明显触痛。于2017年4月来我科就诊。患者自起病以来精神、饮食及睡眠无明显变化,体力及体重无改变,二便正常。既往有系统性红斑狼疮及脑膜瘤病史,否认外伤及蚊虫叮咬史,否认传染病史。     

动脉瘤样纤维组织细胞瘤1例

1病历摘要 患者男,41岁.因左上肢无痛性皮肤结节2年于2017年10月12日就诊于我科门诊.患者2年前无明显诱因于左上肢出现一皮肤结节,约绿豆大,无明显自觉症状.随后缓慢增大,表面无破溃、出血等.曾就诊于当地医院皮肤科,诊断为"表皮囊肿?",未予组织病理检查及治疗.患者既往体健.否认特殊接触史、外伤史及虫咬史,家族成...     

动脉瘤样皮肤纤维组织细胞瘤二例

临床资料 例1,女,50岁。主因右大腿外侧蓝褐色肿物5年、伴疼痛1年,于2010年1月28日到我院就诊。5年前患者右大腿外侧出现一绿豆大小的蓝褐色丘疹,无特殊不适。近1年来皮损扩大明显,并伴有疼痛感。体格检查：系统检查未见异常。皮肤科检查：右大腿外侧一蚕豆大小、隆起性蓝褐色肿物（图1a）,触之质软,有囊性感,有轻触痛。     

深部良性纤维组织细胞瘤一例

深部"良性"纤维组织细胞瘤是一种罕见的纤维组织细胞肿瘤,好发于四肢,本文报道1例.患者,女,56岁,左前臂无痛性皮下肿物4年,组织病理示境界清楚的单发性圆形皮下肿物,约1.8 cm×1.3 cm×0.6 cm,周围有纤维性假包膜,肿瘤细胞丰富,呈梭形或类圆形,编织状致密排列,细胞无明显异型性.免疫组化:CD34(+),...     

乳房部位硬斑病12例临床及组织病理特征分析

目的 探讨累及乳房部位硬斑病患者的临床及组织病理学特征,为临床诊治提供参考。方法 回顾性分析2011年10月-2021年10月于本科确诊的12例乳房部位硬斑病患者的病历资料,总结分析患者的临床、病理特征及其诊断和治疗情况。结果 12例患者中,女11例,男1例,中位年龄为35.5(22,47.3)岁,中位病程为12(4.5,33)个月。临床表现为乳房部位暗红色、黄白色或褐色萎缩性或硬化性斑片,部分皮损表面有蜡样光泽。皮损累及右乳8例(66.67%)、左乳3例(25.00%),1例为累及双侧乳房;皮损位于乳房外上象限3例,外下象限3例,内上象限3例,内下象限1例,其余2例广泛累及全乳;12例患者中乳晕受累者共4例(33.33%)。皮损组织病理示：水肿期主要表现为真皮胶原增生伴明显炎症浸润;硬化期及萎缩期则以真皮胶原增生均质化为突出表现,皮肤附属器减少或消失,血管周围炎症浸润较轻。患者早期多无明显自觉症状。结论 乳房部位的硬斑病早期不易察觉,容易误诊或漏诊,提示乳房部位出现无症状性局限性皮肤颜色改变应警惕乳房硬斑病。     

动脉瘤样纤维组织细胞瘤1例

<正>动脉瘤样纤维组织细胞瘤(aneurysmal fibrous histiocytoma,AFH)是皮肤纤维瘤的异型,临床少见,组织病理表现为在纤维组织细胞瘤结构中出现含血的腔隙。临床、组织病理上应注意与黑素瘤、血管瘤等鉴别。1病历摘要患者男,61岁。因右膝关节下方丘疹8年,明显增大1年,于2013年7月5日到我院就诊。患者8年前     

Dermatofibroma in a black tattoo: report of a case

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in litetature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.     

Aneurysmal fibrous histiocytoma: an unusual variant of cutaneous fibrous histiocytoma

Aneurysmal fibrous histiocytoma (AFH) (Santa-Cruz DJ, Kyriakos M. Aneurysmal ('Angiomatoid') fibrous histiocytoma of the skin. Cancer 1981;47:2053-2061) is a distinct but poorly recognized clinicopathological variant of cutaneous fibrous histiocytoma (CFH) that may result from the slow extravasation of blood into the tumour. The resulting lesion can have a very different clinicopathological appearance resulting in diagnostic confusion. We describe a patient with an AFH that presented as a pigmented nodule on the foot and discuss clinical recognition and histological differentiation from other tumours.     

Immunohistochemical analysis of S100-positive epidermal Langerhans cells in dermatofibroma

Dermatofibroma is a dermal fibrohistiocytic neoplasm. The Langerhans cells are the immunocompetent cells of the epidermis, and they represent the first defense barrier of the immune system towards the environment. The objective was to immunohistologically compare the densities of S100-positive Langerhans cells in the healthy peritumoral epidermis against those in the epidermis overlying dermatofibroma (20 cases), using antibodies against the S100 molecule (the immunophenotypic hallmark of Langerhans cells). The control group (normal, healthy skin) included ten healthy age and sex-matched individuals who underwent skin biopsies for benign skin lesions. A significantly high density of Langerhans cells was observed both in the epidermis of the healthy skin (6.00 ± 0.29) and the peritumoral epidermis (6.44 ± 0.41) vs. those in the epidermis overlying the tumor (1.44 ± 0.33, p < 0.05). The quantitative deficit of Langerhans cells in the epidermis overlying dermatofibroma may be a possible factor in its development.     

Benign fibrous histiocytoma of the eyelid with an unusual clinical presentation

Benign fibrous histiocytoma is a common soft tissue tumor that can be deep or superficially located. Although the deep type of fibrous histiocytoma has a predilection for the orbit, the eyelids are an unusual location for the cutaneous type. A 42-year-old woman had bilateral yellowish nodular masses of the eyelids for two years. Pathological examination after excision revealed benign fibrous histiocytoma. Our case is an unusual clinical presentation of cutaneous fibrous histiocytoma as well as a rare location such as the eyelids.     

Wells' syndrome: a clinical and histopathologic review of seven cases

Wells' syndrome, or eosinophilic cellulitis, is characterized clinically by an acute dermatitis resembling cellulitis, which evolves into violaceous plaques that resolve spontaneously without scarring. The histopathologic features are dynamic, starting with dermal edema and infiltration of eosinophils, the development of "flame figures," and finishing with the appearance of phagocytic histiocytes. We present the clinical and histopathologic features of seven cases of eosinophilic cellulitis.     

Lymphomatoid papulosis in association with mycosis fungoides: A clinical and histopathologic review of five Taiwanese cases

Background/ObjectivesLymphomatoid papulosis (LyP) is a cutaneous CD30+ lymphoproliferative disorder characterized by recurrent, self-healing lesions with a chronic clinical course. Approximately 10–20% of the patients have lymphomas, including mycosis fungoides (MF). LyP in association with MF is not well documented in Taiwan. We aimed to describe the clinicopathologic characteristics of LyP with MF in a Taiwanese case series of LyP.MethodsA retrospective clinicopathologic study was performed on cases of LyP with MF diagnosed in our Department during the period 1990–2012. The diagnosis of LyP and MF were based on their characteristic clinical and pathologic features as well as correlation with the clinical course of the specific skin lesions.ResultsA total of 24 cases of LyP (10 males and 14 females, age 18–63 years, mean 40.4 years) were included. Multiple biopsies were often done in individual patients during the clinical course to establish the diagnosis of LyP and MF. LyP was further classified pathologically as type A (n = 16), B (n = 3), C (n = 3), and mixed type with A&B (n = 1) and A&C (n = 1). Five cases (21%) also had MF; two had juvenile-onset LyP and three had juvenile-onset MF (one with hypopigmented MF, one with hyperpigmented MF, two with CD8+ LyP, and two with CD8+ MF). In the case of juvenile-onset hypopigmented CD8+ MF, the patient developed CD8+ LyP 25 years after the onset of MF and died of aggressive epidermotropic CD8+ lymphoma involving the skin and lung.ConclusionMF occurred in five of the 24 cases (21%) in the present series of LyP. These five cases had several unusual clinical and pathologic features, including subtle or uncommon skin manifestation of MF and more frequent juvenile-onset and CD8 phenotype of LyP and/or MF lesions. Long-term follow-up and repeated biopsy of selected skin lesions are necessary for correct diagnosis and proper treatment of both diseases.     

32例幼年黄色肉芽肿临床与病理分析

 目的:归纳总结幼年黄色肉芽肿的临床及组织病理特点。方法:回顾性分析2011年12月-2019年12月我院确诊的32例幼年黄色肉芽肿患儿的临床资料和组织病理学检查结果。结果:32例患儿皮损多表现为头面部、躯干、四肢黄色或黄褐色丘疹、结节,也可表现为红色或暗红色,有1例伴皮肤外症状。皮损组织病理特点可分为3种类型：早期（占12.50%）,可见大量组织细胞浸润,散在多核巨细胞、淋巴细胞、少量嗜酸性细胞浸润;成熟期（占78.12%）,可见典型泡沫细胞、多核巨细胞及Touton巨细胞;消退期（占9.38%）,可见梭形细胞,少许组织细胞及多核巨细胞。免疫组化结果为CD68（+）、CD1a（-）、Langerin（-）及S-100（-）。结论:临床上根据典型皮损特点及病理表现一般可诊断幼年黄色肉芽肿,但临床上有必要行病理检查以帮助减少误诊率。