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1.
Foreign bodies in sarcoidosis   总被引:2,自引:0,他引:2  
Sarcoidosis is a multisystem disease of unknown etiology. The demonstration of polarizable foreign bodies in cutaneous granulomas is generally thought to exclude a diagnosis of sarcoidosis. Nevertheless. some investigators have reported systemic sarcoidosis with cutaneous manifestations in which polarizable particles were associated with granuloma formation in the skin. We searched the biopsy specimens of granulomatous lesions from 50 patients with cutaneous sarcoidosis using polarization microscopy to estimate the frequency of polarizable foreign bodies in cutaneous lesions of sarcoidosis. Using electron probe microanalysis, we sought to determine what elements compose these foreign bodies. Polarizable foreign bodies were found in the granulomatous skin lesions of 12 of 50 patients with cutaneous sarcoidosis. All 12 patients also had at least one other granulomatous systemic lesion, and 4 had biopsy specimens of a systemic lesion available for review. Polarizable foreign bodies were found in two cases. The elements identified were calcium, phosphorus, silicon, and aluminum. Polarizable foreign bodies were found in cutaneous sarcoidosis far more often than expected. Foreign bodies were also found in granulomatous systemic lesions. The foreign body may serve as an inciting stimulus for granuloma formation in selected cases of sarcoidosis.  相似文献   

2.
Sarcoidosis is a granulomatous disease of unknown etiology, which may affect multiple organ systems. The skin is involved in up to one‐third of cases. The development of granulomatous lesions within tattoos is a well‐recognized phenomenon in patients with sarcoidosis. The characteristic histology shows non‐caseating granulomas; however similar findings may be seen in foreign body granulomas. We report on a patient, who developed sarcoidal granulomas within the black pigment of his tattoos. This subsequently led to the diagnosis of pulmonary sarcoidosis.  相似文献   

3.
Using an immunofluorescent technique, the localization of angiotensin converting enzyme (ACE) was investigated in granuloma lesions from the skin of three sarcoidosis cases. Specific fluorescence was observed in epithelioid cells in the sarcoidosis granulomas examined. However, it was not found in any other granulomatous diseases observed as controls, which included granuloma annulare, foreign body granuloma and lupus miliaris disseminatus faciei. These results indicate that ACE is specifically localized in the epithelioid cells in cutaneous granuloma lesions of sarcoidosis; in one case, it was also observed in Langhans giant cells. Therefore, it is suggested that examination for ACE in cutaneous lesions using an immunofluorescent technique is very useful for the diagnosis of sarcoidosis in the skin. We suggest that epithelioid cells of granulomas in sarcoidosis cutaneous lesions may play an important role in the increase of serum ACE activity.  相似文献   

4.
Pulse granulomas are rare foreign body reactions to vegetable material characterized by hyaline rings or starch granules. Pulse granulomas have mainly been reported in association with lung aspirations, the oral cavity with a history of oral procedures and less frequently in intestinal fistulae, colonic diverticulae or stomach ulcers. Only one case involving the skin has been reported in a patient with jejunocutaneous and ileocutaneous fistulae. We report the second cutaneous pulse granuloma in a patient with a rectocutaneous fistula.  相似文献   

5.
We report the case of a patient who developed sarcoid granulomas 11 months after starting treatment with pegylated interferon alfa and ribavirin for chronic hepatitis C. The sites of the lesions were related to 3 different foreign bodies: silica in old scars on the skin, hyaluronic acid that had been injected into facial tissues, and silicone in an axillary lymph node draining the area of a breast implant. Systemic sarcoidosis was diagnosed on the basis of a history of dry cough and fever and blood tests that revealed elevated angiotensin converting enzyme and liver enzymes. Interruption of the antiviral therapy led to normalization of liver function tests and disappearance of the skin lesions and lymphadenopathies. Dermatologists and cosmetic surgeons should be aware of the risk of sarcoid lesions related to cosmetic implants in patients who may require treatment with interferon in the future.  相似文献   

6.
BACKGROUND: Sea-urchin granuloma is a chronic granulomatous skin lesion caused by injury with sea-urchin spines. Frequently these lesions occur on the hands and develop several months after the initial injury. Classified as an allergic foreign-body reaction, their most common histological pattern resembles sarcoid. The purpose of this study was to evaluate the light microscopic features of biopsies from lesions clinically diagnosed of sea-urchin granolomas. METHODS: We retrospectively reviewed 50 biopsy specimens corresponding to 35 patients with sea-urchin granulomas. These lesions were caused by injuries with the spines of the sea-urchin Paracentrotus lividus. Data were collected between 1990 and 1999 from patients in the seashore of Galicia (NW Atlantic coast, Spain). RESULTS: The cohort consisted of 35 patients (31 males, 4 females), with a median age of 35 years (range 14-60 years). The median duration of the disease was 7.5 months (range 2-60 months). We identified different histopathologic patterns. A granulomatous reaction was observed in 39 biopsies (78%). In 70% corresponding to 35 biopsies this granulomatous reaction was predominant. Foreign-body, sarcoidal, tuberculoid, necrobiotic and suppurative granulomas were identified. The remaining 15 biopsies (30%) showed a predominant inflammatory reaction with features of non-specific chronic inflammation or suppurative dermatitis. A panel of histopathologic features, including epidermal and dermal changes were evaluated. Presence of focal necrosis and microabscesses were common findings. In 50% of our specimens we found umbilication and/or perforation. Additional features included the presence of inclusion epidermoid cysts in four cases and squamous syringometaplasia in one case. CONCLUSIONS: Our observations suggest that sea-urchin granuloma span a wide morphologic spectrum. A granulomatous inflammatory reaction was predominant, with the foreign body and sarcoidal types the most frequent patterns. Other histopathologic patterns with non granulomatous inflammation can be noted. Some features, such as the frequency of perforation and the presence of necrobiotic granulomas have not previously been recognized in the literature.  相似文献   

7.
BACKGROUND: Granulomas may be classified as palisaded, sarcoidal, tuberculoid, suppurative and foreign body. In cancer patients they are defined as tumour-related sarcoid granulomas. Otherwise they are classified as granulomatous lesions of unknown significance. It is still unknown why neoplastic diseases are sometimes associated with granulomas. OBJECTIVES: To investigate granulomas found on the same side as a previous mastectomy. METHODS: We studied four women who had previously undergone mastectomy and presented with epithelioid cell granulomas of the same side as the previous mastectomy. CONCLUSIONS: The association between breast cancer and host granulomatous reaction is uncommon. The cases discussed may correspond to cutaneous tumour-related sarcoid granuloma reactions.  相似文献   

8.
In recent years, the demand for cosmetic interventions to augment soft tissue by injecting different substances has increased, due to their apparent innocuity. However, these procedures are not free from adverse reactions, such as the formation of foreign body granulomas, a phenomenon described in literature with most of the materials used. We report the case of a female patient with inflammatory lesions of the face, whose diagnosis was made after the histopathological study, which revealed a granuloma caused by liquid silicone.  相似文献   

9.
Allergic granulomatosis is a rare life-threatening systemic disorder of unknown origin, which represents a variant of systemic necrotizing vasculitis affecting medium-sized arteries and venules. Histologically, allergic granulomatosis is characterized by vascular and extravascular necrotizing palisading granulomas with prominent eosinophilia (Churg-Strauss granulomas). The clinical criteria include atopy with severe allergic asthma, pronounced peripheral eosinophilia, and nodular infiltrates of the skin and internal organs (Churg-Strauss granulomas). The internal organs most commonly involved are the lungs, gastrointestinal tract and, less often, the peripheral nerves, heart, and kidneys. Associated symptoms include fever, arthralgias and skin rashes, such as erythema multiforme, necrotizing venolitis, fixed drug eruption, and urticaria. Allergic granulomatosis shares common features with Wegener's granulomatosis and polyarteritis nodosa and may be related to the latter condition; overlap syndromes are a well-known occurrence. Similar to the other manifestations of systemic necrotizing vasculitis, immune complexes have been detected in fresh lesions and are suspected of being the basic pathogenetic findings. The causative antigens are likely to be respiratory antigens. The prognosis of untreated allergic granulomatosis is poor (mortality of approximately 50% within the first year). Systemic corticosteroids and cyclophosphamide are effective; complete remissions following cyclophosphamide treatment have been reported.  相似文献   

10.
Penetrating trauma from sea urchin (Echinoidea) spines has been shown to cause numerous cutaneous reactions, ranging from initial pain that rapidly dissipates and resolves to chronic inflammation and formation of characteristic sea urchin granulomas. Many of these skin‐colored or violaceous papules and nodules form weeks to months after injury, and may be surgically excised. Histopathologic examination commonly shows well‐defined granulomas, the majority of which represent sarcoidal‐type granulomas. Other microscopic patterns, such as foreign body reactions and chronic inflammation, have also been shown. Retained spine fragments are birefringent on polarized microscopic examination and are most likely found in the dermal layer. Herein, we describe a case of traumatic sea urchin cutaneous injury with a unique early cutaneous trauma reaction in a young male who lived in Hawaii. Histopathologic exam was significant for retained spines in the layer of the stratum corneum, but no signs of granulomatous inflammation were observed. This case report emphasizes the unique features of our case and reviews the common clinical and histopathologic features of sea urchin cutaneous reactions.  相似文献   

11.
【摘要】 目的 探讨游泳池肉芽肿的临床病理特征。方法 回顾性分析2018年1月至2021年1月天津市中医药研究院附属医院56 例游泳池肉芽肿的临床及病理特点。结果 56例患者中,男16例,女40例,平均年龄 60.84 岁。水产从业人员及居民日常烹饪中处理受感染的鱼或海产品是本组病例感染的主要暴露方式(31/56),平均潜伏期4.58周,平均诊断时间为3.19个月;56例患者皮损均位于上肢,以红斑、丘疹结节为主,有时表现为脓疱、溃疡、肉芽肿或疣状斑块。单发孤立性皮损11例,36例表现为孢子丝菌病串珠样皮损,6例表现为双侧串珠样皮损。组织病理学上除4例无特异性改变外,52例患者表现为感染性肉芽肿,其中37例出现特征性的渗出坏死,中央为不等量的纤维素样渗出或坏死物,其内或周边伴随大量中性粒细胞、组织细胞及多核巨细胞浸润。56例病原微生物宏基因组DNA测序均检测到海分枝杆菌序列。结论 天津地区游泳池肉芽肿以老年女性患病为主,处理受感染的鱼或海产品是最主要的暴露方式,组织病理可表现为特征性的渗出坏死性肉芽肿。  相似文献   

12.
Necrobiotic xanthogranuloma in paraproteinemia   总被引:1,自引:0,他引:1  
Necrobiotic xanthogranuloma is a rare generalized dermatosis occurring exclusively in association with paraproteinemia. Clinically it is characterized by large, ulcerating, nodular and plaque-like tumors of the dermis and subcutis. Histologically the lesions are composed of a nonspecific, lymphocytic and plasmacellular infiltrate and highly characteristic granulomas with giant cells of the Touton and foreign body type. Ultrastructurally, tubular cystic organelles with a central lamella and a few ribosomes at their outer membranes are found. By means of histochemical studies we excluded the skin infiltrates as the site of the paraprotein release. The pathogenesis of the disease remains unclear; it is suggested that the paraprotein has functional features of a lipoprotein, which may bind to lipoprotein receptors of the histiocytes, thereby inducing xanthoma formation.  相似文献   

13.
BACKGROUND: Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology in which skin involvement is frequent. OBJECTIVE: To review histological characteristics of biopsies of specific cutaneous lesions of sarcoidosis and their relationship with clinical course. PATIENTS AND METHODS: Biopsies from 32 patients with specific cutaneous sarcoidosis were reviewed. Histological findings and clinical characteristics of these patients were analysed. RESULTS: The initial clinical lesions of the patients were ten infiltrated nodule-plaques, eight papules, four maculopapular eruptions, five scar sarcoidosis, four subcutaneous nodules and one lupus pernio. Sarcoidal granulomas were located at dermis in 31 cases (74%) and at subcutaneous fat in 12 (28%) but only four were subcutaneous exclusively. Perivascular or periannexial distribution of granulomas was observed in eight cases (19%) and they had coalescence in 29 samples. The presence of foreign material was demonstrated in 11 cases (26%). CONCLUSIONS: Clinical spectrum of specific lesions of cutaneous sarcoidosis showed a good correlation with granulomas localization in the biopsies. However, traditional classification of specific cutaneous sarcoidosis is often overlapping. On the other hand, foreign bodies and other atypical histological findings were more common than initially expected.  相似文献   

14.
Cutaneous sarcoidosis often masquerades as many other disease entities. We describe the case of a 56-year-old African American man with a 1-year history of progressively enlarging nodules and plaques of the face resulting in a leonine appearance and madarosis. The diagnosis of cutaneous sarcoidosis was made after skin biopsy results revealed noncaseating granulomas without evidence of foreign body, mycobacteria, or deep fungal infection. A thorough systemic workup was void of other comorbidities. The reports of tumoral sarcoidosis or sarcoidosis presenting with leonine facies are rare, and those cases that have been reported have been linked to other systemic findings.  相似文献   

15.
Two female patients presented nodular erythematous lesions overlying a permanent tattooed eyebrow and lip, respectively. Histologic examination showed in both cases epithelioid granulomas in close relation with scattered pigment. Complementary examinations and follow-up disclosed a sarcoidosis. The lesions resolved after treatment with topical steroids and also oral allopurinol in one of the cases. Allopurinol may be an effective treatment for granulomatous reactions to foreign body particles.  相似文献   

16.
淋巴瘤可伴发皮肤肉芽肿,其模式主要有两种:一种是淋巴瘤的特异性皮损中出现肉芽肿反应,例如肉芽肿性蕈样肉芽肿和肉芽肿性皮肤松弛症;另一种是淋巴瘤出现非特异的肉芽肿性皮损,主要见于一些系统性淋巴瘤.其组织病理学类型可为结节病样、环状肉芽肿样、结核样等.其机制及其与预后的关系尚不明确.肉芽肿形成可能是造成某些淋巴瘤特殊临床表现的原因,也容易掩盖淋巴瘤的真实面目,在临床和组织学诊断上需谨慎.  相似文献   

17.
Immunohistochemical study of lysozyme in lupus miliaris disseminatus faciei   总被引:1,自引:0,他引:1  
The lysozyme activity in tissue samples from patients with lupus miliaris disseminatus faciei (LMDF), sarcoidosis and foreign body granuloma was investigated using the immunoperoxidase technique. The majority of epithelioid cells and giant cells in LMDF and sarcoidosis showed strong lysozyme staining in their cytoplasm. However, most macrophages and giant cells in foreign body granulomas, including granulomatous reactions to epidermal cysts and other foreign materials, stained weakly for lysozyme or were negative. These results suggest that LMDF is different from the foreign body reaction to inert substances, and may be induced by an immunological mechanism associated with cell-mediated immunity.  相似文献   

18.
In a patient with foreign‐body granulomas, dog hairs were identified as the causative agent by combing history, histopathology and highly sensitive detection of species‐specific canine mitochondrial DNA. Granulomas from human hair are well known in hairdressers. Animal hair granulomas have so far been only described in dog groomers, milkers, and shearers. To the best of our knowledge this patient represents the first described case of dog hair granulomas in a pet owner.  相似文献   

19.
20.
Injectable cutaneous microimplants may occasionally cause either persistent local irritation or late skin reactions in the form of foreign body granulomas at the injected areas. Permanent elimination of the latter is not easily achieved. The skin of a female patient developed nodules along the treated sites on her face a few months following the last session of intracutaneous injections. Intralesional steroids offered temporary and incomplete clearance. Colchicine was administered orally for better results.  相似文献   

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