伴结节性红斑的大动脉炎2例临床及组织病理分析并文献复习

Two cases of Takayasu arteritis with erythema nodosum:clinical and pathological analysis and literature review

报告2例伴结节性红斑的大动脉炎。例1.患者女,43岁。例2.患者女,21岁。二例患者均因双下肢反复出现结节性红斑就诊,其中例2有间断发热。皮肤科检查:二例患者双下肢均可见散在结节性红斑。二例患者皮损组织病理检查均提示血管周围少许单核细胞或淋巴细胞浸润,皮下脂肪间隔增宽,胶原增生,部分脂肪细胞变性坏死,呈混合性脂膜炎改变。计算机断层摄影血管造影术(CTA)提示2例患者血管管腔均有不同程度的狭窄,例1患者狭窄部位位于头臂干、双侧颈动脉及锁骨下动脉,例2患者位于左锁骨下动脉。诊断:大动脉炎。

Two cases of Takayasu arteritis(TA)with erythema nodosum are reported.Two female patients(aged 43 and 21,respectively)were presented with recurrent nodular erythema in both lower limbs.Case 2 had intermittent fever.Physical examination showed erythema nodosum scattered in both lower limbs.Histopathological examination of the lesions showed a little mononuclear and lymphocyte infiltration around the blood vessels,widening of subcutaneous fat septum,collagen hyperplasia,and degeneration and necrosis of some adipocytes,indicating mixed panniculitis.Computed tomography angiography(CTA)revealed varying degrees of vascular stenosis in these two patients,which was found in brachiocephalic trunk,bilateral carotid artery,and subclavian artery of case 1,and in the left subclavian artery of case 2.The diagnosis of TA was made.