深在型环状肉芽肿20例临床及组织病理分析

Clinicopathologic analysis of twenty cases of deep granuloma annulare

目的：探讨深在型环状肉芽肿临床及组织病理特征。方法：对2009年12月-2014年9月间西京皮肤医院经组织病理确诊的20例深在型环状肉芽肿患儿资料进行回顾性分析。结果：20例患儿中男9例，女11例，年龄1～12岁，平均3．2岁，病程1个月～5年。临床表现均为皮下结节。组织病理均表现为皮下脂肪内上皮样细胞形成栅栏状肉芽肿性结节，20例均可见黏蛋白沉积，18例可见纤维蛋白样坏死，10例可见不同程度的嗜酸性粒细胞浸润。对所有患儿进行电话随访，时间为4个月～5年．其中6例皮损完全消退，6例有新发皮损，1例皮损未见明显变化，3例失访。结论：深在型环状肉芽肿主要发生于儿童，表现为头部或四肢的皮下结节。组织病理表现为皮下脂肪栅栏状上皮样细胞肉芽肿，可见纤维蛋白样坏死和黏液沉积，常伴有嗜酸性粒细胞浸润。

Objective： To investigate the clinicopathological features of deep granuloma annulare（DGA）. Methods： The clin- ical and pathological data of 20 cases of DGA were retrospectively analyzed in the Xijing Hospital from December 2009 to September 2014. Results： There were 9 males and 11 females, aged 1-12 years old, with a mean age of 3.2-year-old, and the duration of disease was 1 month to 5 years. Clinical manifestations were subcutaneous nodules. Histopathology showed epithelioid cells in the subcutaneous fat formed into palisaded granulomatous nodules in the subcutaneous fat, mucin deposi- tion in 20 cases, fibrinoid necrosis in 18 cases, and different degrees of eosinophil infiltration in 10 cases. All patients were followed up by telephone for 4 months to 5 years, 6 cases of skin lesions disappeared completely, new-onset of lesions in other six cases, no change in one case, and 3 cases were loss of follow-up. Conclusions： DGA mainly occurs in children, manifests as subcutaneous nodule in the head or limbs. Histopathology shows palisaded epithelioid cell granuloma in the subcutaneous fat, fibrinoid necrosis and mucin deposition could be seen and accompanied by eosinophil infiltration.