鲍文样丘疹病的临床与病理观察

Clinical and pathologic observation on Bowenoid papulosis

目的：研究鲍文样丘疹病的病因、临床病理特征及鉴别诊断要点。方法：对１５例患者进行临床病理分析；１２例用ＰＣＲ方法检测ＨＰＶ、ＨＳＶ－Ⅱ、ＣＭＶ、ＣＴ、ＮＧ、ＵＵ等６种病原体及免疫组化ＰＣＮＡ检测；跟踪观察部分病人病情变化。结果：鲍文样丘疹病大体观有典型形态特征，镜下与鲍文病类似，可表现有棘细胞的轻～重度不典型增生，核分裂象易见。６种病原体检查部分呈阳性，但未发现明确相关性。随访观察１～７年，预后良好。该病有一定的自愈性，治疗后不易复发。结论：鲍文样丘疹病组织学可表现为轻～重度不典型增生，类似鲍文病和鳞癌，诊断宜结合临床形态观察。

Purpose To investigate the etiology, clinicopathologic characteristics and differential diagnosis of Bowenoid papulosis (BP). Methods Fifteen cases of BP were studied clinicopathologically. Twelve cases were studied by PCR to detect the pathogens of HPV, HSVⅡ, CMV, CT, NG and UU, and by PCNA immunostaining. Ten cases were followed up. Results BP had a typical morphological characteristics grossly and was similar to Bowens disease histologically, which showed mild to florid hyperplasia of the cells in the spinosum layer with easily seen mitoses. There was no significant relation between the disease and the pathogens although some cases were positive with them. A good prognosis was shown after 1 to 7 years followup. Conclusion The presence of mild to severe cytological atypia is a feature of BP. The diagnosis should be made both in clinic and pathology. The disease may be spontaneously regression.