面部结节性筋膜炎

Facial nodular fasciitis

报告1例面部结节性筋膜炎。患者男,36岁。左侧颧部皮下结节半年。皮肤科检查:左侧颧部触及蚕豆大皮下结节,无压痛,活动欠佳,质中等。超声检查:左侧面颊探及17.0 mm×8.6 mm规则低回声结节,边界清。皮损组织病理:皮下大量梭形细胞,胶原水肿伴黏液样变性,黏液样基质中见毛细血管增生及红细胞外渗。免疫组化:波形蛋白(vimentin)、平滑肌肌动蛋白(SMA)阳性;结蛋白(desmin)、S-100蛋白及CD34阴性。基因检测:荧光原位杂交(FISH)断裂探针检测泛素特异性蛋白酶(USP)6基因发生断裂。诊断:结节性筋膜炎。治疗:皮损完整切除,随访至今未复发。

A case of facial nodular fasciitis is reported.A 36-year-old male presented with subcutaneous nodule on the left zygomatic region for half a year.Physical examination showed a large subcutaneous nodule of broad bean was touched on the left zygomatic part,without tenderness,with poor mobility and medium texture.Ultrasonography showed a 17.0mm×8.6mm regular hypoechoic nodule on the left cheek with a clear border.Histopathological examination showed the lesion was located subcutaneously with a large number of spindle cells,accompanied by collagen edema and myxoid degeneration.Capillary hyperplasia and erythrocyte extravasation were observed in the myxoid matrix.Immunohistochemistry showed vimentin and SMA were positive,while Desmin,S-100 and CD34 were negative.Gene detection showed fluorescence in situ hybridization(FISH)cleavage probe detected the cleavage of ubiquitin-specific protease(USP)6 gene.The diagnosis of nodular fasciitis was made.The skin lesion was completely removed,with no recurrence up to now.