9例血管瘤样Spitz痣临床及组织病理分析

Clinical and histopathologic characteristics of 9 angiomatoid Spitz nevus cases

目的:分析血管瘤样Spitz痣的临床、组织病理和免疫组化特征。方法:回顾性分析2005年——2020年第四军医大学西京皮肤医院确诊的9例血管瘤样Spitz痣的临床和组织病理特点。结果:9例血管瘤样Spitz痣患者中男5例,女4例。组织病理表现为真皮内上皮样、梭形细胞或两者混合增生,散在或呈小巢状分布在增生的厚壁小血管周围及增粗的胶原纤维间,痣细胞间及血管周围可见较多的肥大细胞浸润。免疫组化显示增生的细胞均表达S-100蛋白、S-100A6蛋白和Melan-A,血管内皮细胞CD31阳性且平足蛋白(D2-40)阴性。结论:血管瘤样Spitz痣是Spitz痣罕见的组织亚型,其组织病理有一定特征性,应注意与血管肿瘤及退行期的恶性黑素瘤相鉴别。

Objective:To analyze the clinical,histopathological,and immunohistochemical characteristics of angiomatoid Spitz nevus.Methods:A retrospective analysis was performed on 9 angiomatoid Spitz nevus cases diagnosed in our department from2005 to 2020.Results:Among the 9 patients,5 were males and 4 were females.The histopathology results showed proliferation of intradermal epithelial cells or spindle cells scattered or nested around the thickened walls of small blood vessels or between the obviously proliferated collagen fibers.Many mast cells were found infiltrated among nevus cells and around the blood vessels.Immunohistochemistry showed that the proliferated cells were all positive for S-100,S-100 A6 and Melan-A.Vascular endothelial cells were positive for CD31 and negative for D2-40.Conclusion:Angiomatoid Spitz nevus,a rare type of Spitz nevus with distinctive histopathology,should be distinguished from vascular tumors and degenerative malignant melanomas.