环状弹性纤维溶解性巨细胞肉芽肿

Annular elastolytic giant cell granuloma: a case report

报告1例环状弹性纤维溶解性巨细胞肉芽肿。患者男,59岁。躯干、四肢起红色丘疹和环状斑块4年余,加重1年。皮损组织病理检查示真皮浅中层可见散在分布较多淋巴细胞、组织细胞、上皮样细胞和局部群集的多核巨细胞浸润。阿辛蓝染色阴性。弹性纤维染色示真皮浅中层弹性纤维明显减少、缺失,部分多核巨细胞内可见吞噬的弹性纤维。结合临床、组织病理、阿辛蓝染色和弹性纤维染色,诊断为环状弹性纤维溶解性巨细胞肉芽肿。临床上,该病需与环状肉芽肿和光化性肉芽肿鉴别。

A case of annular elastolytic giant cell granuloma is reported. A 59-year-old man presented with red papules and annular plaques on the trunk and the extremities for over 4 years, which aggravated for over 1 year. Histopathological examination demonstrated an infiltration of lymphocytes, histiocytes, epithelioid cells and multinuclear giant cells in the middle and the upper dermis. Alcian blue stain was negative. Elastic tissue staining showed a reduction or absence of elastic fibers in the middle and the upper dermis. Engulfed fragments of elastic fibers could be seen in some muhinucleated giant cells. These findings are consistent with annular elastolytic giant cell granuloma. Differential diagnosis must be made with granuloma annular and actinic granuloma.