栅栏状包膜神经瘤七例分析

目的 探讨栅栏状包膜神经瘤的临床和组织病理特点.方法 回顾性分析7例栅栏状包膜神经瘤的一般情况、临床表现和组织病理表现.结果 7例患者平均发病年龄32岁(22～41岁),男女比例为2∶5.皮损均为单发孤立的小丘疹,质地由软到韧,呈皮肤颜色、红色或黄白色,均无自觉症状.组织病理表现为真皮内界限清楚、有包膜的良性肿瘤,以Schwann细胞增生为主,呈束状排列,肿瘤组织间可有人工裂隙.免疫组化检查肿瘤细胞S100抗体阳性,平滑肌肌动蛋白抗体阴性;上皮细胞膜抗原抗体在肿瘤包膜阳性.结论 栅栏状包膜神经瘤主要依靠组织病理诊断.临床上需要与神经鞘瘤、神经纤维瘤及平滑肌瘤等鉴别.     

发生于手部的栅栏状有包膜神经瘤

报告1例发生于手部的栅栏状有包膜神经瘤。患者男,82岁。右手拇指肤色结节10余年。皮肤科检查:右手拇指外侧一边界清楚,直径0.5 cm的肤色结节,表面光滑。皮损组织病理检查:表皮大致正常,真皮中部见边界清楚的圆形或卵圆形结节,周围有增厚的胶原纤维包膜,其内为相互交织的梭形细胞束,梭形细胞胞核细长,可见裂隙。免疫组化:肿瘤细胞S-100蛋白(+)及神经束膜细胞上皮膜抗原(EMA)(+)。诊断:栅栏状有包膜神经瘤。     

丛状栅栏状有包膜神经瘤

报告1例丛状栅栏状有包膜神经瘤。患者男,42岁。右口角外侧丘疹8年。皮肤科检查:右口角外侧一肤色丘疹,质中,表面光滑。皮损组织病理:真皮内可见多个肿瘤团块,境界清楚,瘤团内梭形细胞增生,其间可见较多裂隙,瘤团外层细胞呈栅栏状排列,细胞异形性不明显。免疫病理:增生的梭形瘤细胞S-100蛋白阳性,肿瘤细胞间可见散在神经纤维丝蛋白(NFPR)阳性的神经轴突,肿瘤周围可见上皮膜抗原(EMA)弱阳性的不完整的包膜。诊断:丛状栅栏状有包膜神经瘤。     

皮肤栅栏状包囊性神经瘤

报告1例表现为面部结节的皮肤栅栏状包囊性神经瘤.患儿男,10岁.下颏部淡红色无痛性丘疹、结节半年就诊.根据临床和组织病理改变诊断为皮肤栅栏状包囊性神经瘤.该病诊断主要依靠特异性的组织病理改变.     

双侧腹股沟淋巴结内指突状树突细胞肉瘤1例报道并文献复习

目的：探讨以阴囊肿大为主要表现就诊的双侧腹股沟淋巴结内指突状树突细胞肉瘤（IDCS）的病理特征、临床诊断及鉴别诊断.方法：对1例以阴囊肿大为主要表现的双侧腹股沟淋巴结内IDCS进行病理学检查和免疫组化染色观察,结合文献进行讨论.结果：临床表现为阴囊肿大及双侧腹股沟无痛性肿物.光镜下癌细胞位于淋巴结内,呈边界不清的束状排列,细胞呈卵圆形、梭形弥散分布,核异型性较明显,可见核分裂像.免疫组化瘤细胞S-100蛋白、CD68和CD3表达阳性.结论：IDCS是一种极为罕见的恶性肿瘤,其临床表现各不相同,临床及病理早期均有误诊可能.其诊断依靠病理检查和免疫组化,必要时辅助电镜.应与滤泡状树突细胞肉瘤、恶性黑色素瘤、恶性纤维组织细胞肉瘤、朗格汉斯细胞组织细胞增生症及未分化癌相鉴别.S-100、CD68蛋白是其特异性的标志物.     

面部多发性结节——丛状神经鞘瘤

诊断:丛状神经鞘瘤(plexiform Schwannoma,PS). 皮损组织病理改变:真皮内瘤结节边界清楚,有完整的纤维包膜.与周围组织有裂隙.结节内肿瘤细胞为梭形.密集,呈多个结节状、栅栏状或漩涡状排列,可见Verroeay小体.偶见核异形和核分裂象.病理诊断为丛状神经鞘瘤.     

硬化性神经束膜瘤3例临床及组织病理分析

目的探讨硬化性神经束膜瘤的临床、组织病理和免疫组化特征。方法对2015—2018年第四军医大学西京皮肤医院确诊的3例硬化性神经束膜瘤的临床、组织病理及免疫组化结果进行回顾性分析。结果 3例患者均为女性,就诊年龄为8～25岁。肿瘤均位于手指,表现为小丘疹。组织病理显示硬化的胶原束间上皮样或梭形神经束膜细胞增生,细胞排列成束状或旋涡状。肿瘤细胞表达EMA,Claudin-1和GLUT1,不表达S-100和CD34。结论硬化性神经束膜瘤相对罕见,皮损好发于年轻人手指,EMA,Claudin-1,GLUT1免疫组化有助于确诊。     

结外鼻型NK/T细胞淋巴瘤4例及临床与病理分析

目的探讨结外鼻型NK/T细胞淋巴瘤的临床及组织病理学特点。方法分析4例患者的皮疹特点、实验室检查和组织病理等临床资料。结果4例患者中男1例,女3例,平均年龄52.5岁,皮损表现为溃疡、肿块和紫癜等,其中3例患者皮损均发生于面部,1例患者皮损发生于下颌及双下肢,组织病理检查示瘤细胞的弥漫性浸润,细胞大小不等,瘤细胞异型性明显;免疫组织化学显示瘤细胞表达CD56、CD3ε、粒酶B,EBER1/2原位杂交阳性。结论结外鼻型NK/T细胞淋巴瘤具有独特的组织病理及免疫组化特征,皮损临床表现、常规实验室检查亦对诊断有提示意义。     

家庭内感染麻风二例

患者,男,15岁。右下肢出现鸡蛋大环状红斑1年,伴轻度瘙痒。组织病理检查：表皮基本正常,真皮血管和附属器周围灶状淋巴细胞,组织细胞浸润,可见神经束轻度粗大和水肿,炎症细胞移入。抗酸染色阳性2+。临床表现结合病理检查,诊断为BB。 患者母亲,40岁。右小腿麻木6年余,周身散在斑片1年。组织病理检查：表皮轻度萎缩,真皮血管和附属器周围灶状淋巴细胞为主的炎症细胞浸润,可见神经束轻度粗大,炎症细胞移入。抗酸染色阳性1+-2+。临床表现结合病理检查结果,诊断符合BL。     

栅状有包膜神经瘤一例

摘要：报道一例栅状有包膜神经瘤,患者女,34岁,上唇皮疹5年。根据临床和组织病理改变诊断为皮肤栅状包囊性神经瘤。     

环氧化酶-2在表皮肿瘤中的表达

目的 探讨环氧化酶-2在不同表皮肿瘤中的表达及意义。方法 选择鳞状细胞癌8例、基底细胞上皮瘤10例、Bowen病8例和脂溢性角化病12例,运用免疫组化方法观察肿瘤细胞中环氧化酶-2的表达。结果 与正常表皮相比,环氧化酶-2在鳞状细胞癌、Bowen病、基底细胞上皮瘤中的表达明显上调,尤其以鳞状细胞癌中的表达最强。而环氧化酶-2在脂溢性角化病中的表达与正常人皮肤的表达近似。结论 环氧化酶-2表达的上调可能在表皮肿瘤的发生发展中发挥一定作用。     

Leprosy: a review of laboratory and therapeutic aspects - Part 2

Leprosy is a chronic infectious condition caused by Mycobacterium leprae(M. leprae). It is endemic in many regions of the world and a public health problem in Brazil. Additionally, it presents a wide spectrum of clinical manifestations, which are dependent on the interaction between M. leprae and host, and are related to the degree of immunity to the bacillus. The diagnosis of this disease is a clinical one. However, in some situations laboratory exams are necessary to confirm the diagnosis of leprosy or classify its clinical form. This article aims to update dermatologists on leprosy, through a review of complementary laboratory techniques that can be employed for the diagnosis of leprosy, including Mitsuda intradermal reaction, skin smear microscopy, histopathology, serology, immunohistochemistry, polymerase chain reaction, imaging tests, electromyography, and blood tests. It also aims to explain standard multidrug therapy regimens, the treatment of reactions and resistant cases, immunotherapy with bacillus Calmette-Guérin (BCG) vaccine and chemoprophylaxis.     

缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征一例并文献复习

目的了解缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征的临床表现。方法分析1例缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征患者临床表现、实验室检查及治疗反应。结果患者男,54岁,表现为对称性多关节炎及肢端水肿。血清类风湿因子、抗核抗体、抗ds—DNA抗体、抗合成循环瓜氨酸多肽抗体、免疫球蛋白、补体均正常。x线检查示双手掌指骨骨质破坏。糖皮质激素和免疫抑制剂治疗效果好。结论缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征是一组异质性疾病。     

白塞综合征患者抗血管内皮细胞抗体和抗心磷脂抗体的检测

目的 探讨血清抗血管内皮细胞抗体(AECA)及抗心磷脂抗体(ACA)在白塞综合征发病中的作用。方法 收集白塞综合征患者和正常人血清,用间接免疫荧光技术检测血清中AECA并分型,用酶联免疫吸附方法检测ACA。结果 白塞综合征组AECA阳性率为81.3%(32例中26例阳性),其中IgG-AECA阳性率为71.9%,IgM-AECA阳性率为53.1%,与正常人对照组比较差异有显著性(P<0.01)。同时AECA阳性组与阴性组比较在发生结节性红斑或结节性血管炎及血沉增快方面前者高于后者。ACA检测结果,白塞综合征组阳性率为53.1%,显著高于正常人对照组。ACA阳性组与阴性组比较,在口腔溃疡、皮肤、外生殖器及贫血等临床表现及血沉等方面差异无显著性(P>0.05)。结论 白塞综合征患者血清AECA水平对白塞综合征血管损害及病情活动具有一定意义。ACA对病情的影响尚需进一步研究。     

线状和回旋状色素沉着症并发炎性线状表皮痣及寻常性鱼鳞病

报告1例线状和回旋状色素沉着症并发炎性线状表皮痣、寻常性鱼鳞病。患者女,17岁。2岁起胸背部出现线状和回旋状色素沉着,双下肢皮损覆鱼鳞状鳞屑,双手背关节和左侧膝部、踝部、足背关节处可见线状鳞屑性红斑。系统及实验室检查均正常。结合组织病理改变诊断为线状和回旋状色素沉着症并发炎性线状表皮痣、寻常性鱼鳞病。     

Update summarising the conclusions of the international consultation on male lower urinary tract symptoms

The International Consultation on Urological Disease have recently published comprehensive conclusions, based on evidence reviewed by eight committees, on aspects of male lower urinary tract symptoms(LUTS). In this review, we summarise the conclusions from fourof the committees, namely, the evidence regarding the epidemiology of male LUTS, patient assessment, nocturia and medical management. It is indisputable that with an expanding and ageing global population the prevalence of male LUTS is likely to increase. Therefore symptom prevention and preservation of quality of life(Qo L) feature highly in the guidelines. There are now a number of different medical options, proven to lead to significant improvements in symptom scores, flow rate and Qo L available to men with LUTS. Metaanalyses have shown the benefits for alpha blockers, antimuscarinics, 5-α reductase and phosphodiesterase-5 inhibitors. High level evidence also exists for combinations of all of the above with alpha blockers and so men with concomitant storage symptoms, prostate volume 30 mL, PSA 1.4 or erectile dysfunction may be considered for combination treatment of an alpha blocker with an antimuscarinic, 5-α reductase inhibitor or phosphodiesterase-5 inhibitor respectively. In an era of personalised medicine, appropriate patient selection is likely to provide the key to the most effective clinical management strategy.     

Sweet side of bladder cancer

The malignant transformation of cells is often accompanied by deranged expression of the sugar chains,i.e.,glycans,attached the cancer cell surfaces or attached to secreted proteins.The aberrant expression of specific glycans in bladder cancer has also been reported by several research groups.Similarly to other cancers,glycans such as the sialyl Tn antigens have been suggested as diagnostic and prognostic biomarkers of bladder cancer,and associated with disease progression and patient’s response to treatment.At present our understandings about the role of glycans in bladder cancer is still limited,but at the same time it is now assumed that this understanding urges and it will fuel the development of novel strategies of diagnostic and therapy.