反射式共聚焦显微镜与组织病理诊断色素减退性蕈样肉芽肿八例

目的 探讨色素减退性蕈样肉芽肿在反射式共聚焦显微镜(RCM)下的图像特征.方法 选择经组织病理学和免疫组化确诊的8例色素减退性蕈样肉芽肿患者,同一皮损进行RCM扫描及组织病理检查.结果 8例患者RCM表现:轻度角化,表皮内见单个或聚集分布的卵圆形或类圆形中等折光的多形单个核细胞、核周伴弱折光空晕;基底层色素环折光减弱;真皮乳头较多大小不等的多形单个核细胞浸润;部分表皮内可见圆形或类圆形中等折光单个核细胞聚集呈囊泡样结构.RCM与组织病理有较好的一致性.结论 RCM是辅助诊断或鉴别诊断色素减退性蕈样肉芽肿的无创性皮肤影像学检查方法.

Reflectance confocal microscopy combined with histopathology for the diagnosis of hypopigmented mycosis fungoides: eight case reports

Objective To assess the reflectance confocal microscopic (RCM) features of hypopigmented mycosis fungoides (HMF).Methods A total of 8 patients with histopathologically and immunohistochemically diagnosed HMF were enrolled in this study.RCM imaging and histopathological study were both performed to examine lesions at the same site in these patients.A comparison was conducted between confocal microscopic and pathological findings.Results RCM imaging in the 8 cases showed mild hyperkeratosis,and single or clustered,moderately reflective,oval or quasi-circular,polymorphic mononuclear cells with mildly reflective perinuclear halos in the epidermis.The reflectivity of pigmented rings in the basal layer was weakened.Many irregularly sized polymorphic mononuclear cells infiltrated the dermal papilla.Moderately reflective,circular or quasi-circular mononuelear cells gathered to form vesicle-like structures in some areas of the epidermis.RCM images were highly consistent with histopathological findings in these patients.Conclusion RCM may be used as a non-invasive imageological technique in the auxiliary or differential diagnosis of HMF.