期刊文献+

肉芽肿性皮肤松弛症六例临床及病理研究

Clinicopathological analysis of six patients with granulomatous slack skin
原文传递
导出
摘要 目的探讨6例肉芽肿性皮肤松弛症(GSS)的临床和病理特点。方法收集6例GSS患者的临床和病理学资料。结果6例均为男性,皮损为松弛斑块甚至垂悬状肿块,5例发生于皱褶部位(或为主),1例仅发生于右胸部。1例合并蕈样肉芽肿。组织病理均可见真皮内非干酪性肉芽肿,伴中等大小的淋巴样细胞、多核巨细胞浸润。1例见淋巴样细胞异形改变,余5例异形不明显。1例伴有亲表皮现象。免疫组化均见CD4^+T细胞为主的单克隆增生。4例行弹性纤维染色见弹性纤维卷曲、断裂甚至消失,2例见多核巨细胞吞噬弹性纤维现象。2例行T细胞受体(TCR)基因重排,均为1单克隆增生。2例患者采用浅层x线照射或电子束照射,皮损变小后手术切除,未再复发。其余4例患者采用干扰素α-2b肌内注射、0.02%氮芥外用等,症状有改善。结论GSS进展缓慢,不推荐过度治疗。局限于皱褶部位的GSS推荐手术治疗。 Objective To investigate clinicopathological features of granulomatous slack skin (GSS). Methods Clinical and pathological data were obtained from 6 cases of GSS, and analyzed retrospectively. Results All the 6 patients were males, and presented with slack plaques and even pendulous skin folds. These skin lesions mainly affected flexural areas in 5 patients, and only occurred in the right chest in 1 patient. One patient was diagnosed with GSS complicated by mycosis fungoides (MF). Histopathological examination showed non-caseating granulomas with infiltration of medium-sized lymphoid cells and multinucleated giant cells in the dermis in all the patients, atypical lymphoid cells in 1 patient, and epidermotropism in another patient. Immunohistochemical study revealed monoclonal CD4^+ lymphocytosis. Elastic fiber staining was performed in 4 patients, and showed crimp, fracture and disappearance of elastic fibers, and elastic fiber phagoeytized by multinuclear giant cells in 2 patients. There were monoclonal rearrangements of T-cell receptor (TCR) γgene in 2 patients. After radiotherapy with electron beam or superficial X-ray, lesions of 2 patients became smaller, and then were excised completely without recurrence. The other 4 patients received intramuscular injection of interferon α-2b and topical application of 0.02% mechlore-thamine solution, and their condition was improved. Conclusions GSS has a slowly progressive course, and overtreatment is not recommended. Surgical excision may be the first choice for GSS localized in flexural areas.
作者 王光平 王小坡 陈浩 张韡 姜祎群 曾学思 徐秀莲 孙建方 Wang Guangping Wang Xiaopo Chen Hao Zhang Wei Jiang Yiqun Zeng Xuesi Xu Xiulian Sun Jianfang(Department of Pathology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China)
出处 《中华皮肤科杂志》 CAS CSCD 北大核心 2017年第2期95-98,共4页 Chinese Journal of Dermatology
基金 国家自然科学基金(81272992) 江苏省自然科学基金(BK2012505) 国家教育部高等学校博士学科点专项科研基金(20121106110040) 北京协和医学院创新基金(2014-10023-1002-3010)
关键词 淋巴瘤 T细胞 皮肤 皮肤松弛症 蕈样肉芽肿 皮肤表现 病理学 治疗结果 Lymphoma, T-cell, cutaneous Cutis laxa Mycosis fungoides Skin manifestations Pathology Treatment outcome
  • 相关文献

参考文献3

二级参考文献2

共引文献10

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部