儿童皮肤孤立性肥大细胞瘤一例

A case of cutaneous solitary mastocytoma in child

1岁男性患儿,左小腿外侧皮肤小丘疹及水疱1年。患儿出生时左小腿外侧即有一米粒大小红色丘疹,逐渐增大,其表面反复出现孤立性水疱,常搔抓破溃,水疱可自行干涸、结痂。皮损组织病理:真皮中上层大量单一核细胞弥漫性浸润,细胞呈卵圆形、立方形或梭形,胞核圆形或卵圆形,胞质嗜酸性,其内可见嗜酸性颗粒;甲苯胺蓝染色:细胞质内有紫红色异染性颗粒;免疫组化染色示:CD117、CD68、LCA强阳性。诊断为孤立性肥大细胞瘤。单纯手术切除后预后良好,随访至今无复发。

A case of child solitary mastocytoma is reported. A one-year-old boy complained of a small papule and a blister on the lateral side of his left leg for one year. At birth, a red papule about the size of a rice appeared on the lateral side of the left leg and gradually increased in size, and a isolated blister appeared repeatedly on the surface of the papule. The child often scratched the lesion, resulting in local ulceration, which could dry up and scab by itself in a few days. Histopathology of the lesion: a large number of mononuclear cells were diffusely infiltrated in the middle and upper dermis. The cells were oval, cube or spindle shaped, with round or oval nuclei and eosinophilic cytoplasm. Eosinophilic granules could be seen in the cytoplasm. Toluidine blue staining: purplish red heterochromic granules in the cytoplasm. Immunohistochemistry: CD117, CD68 and LCA were strongly positive. It was diagnosed as cutaneous solitary mastocytoma, and the prognosis was good after surgical resection. There was no recurrence in the period of follow-up.