进行性结节性组织细胞瘤

Progressive Nodular Histiocytoma

目的描述进行性结节性组织细胞瘤临床、细胞结构及亚细胞结构的特征。方法 活检组织HE染色、免疫组织化学染色显微镜观察及电镜观察。结果镜下可见活检皮损与周围组织界限清晰,并见多核巨细胞、泡沫样组织细胞和组织细胞,部分区域可见席纹状排列梭形细胞,多核巨细胞、梭形细胞、泡沫样组织细胞、组织细胞CD68、溶酶体标志物染色阳性,S-100蛋白染色阴性。冰冻组织切片苏丹黑染色可见泡沫样组织细胞内脂滴。电镜下未发现Birbeck颗粒和Caputo小体。结论本病应与多发性幼年性黄色肉芽肿、网状组织细胞增生症、发疹性组织细胞瘤、播散性黄瘤病鉴别,该病例可以确立进行性结节性组织细胞瘤诊断。

Objective To describe clinical, cell and sub-cell constraction presentation of progressive nodular histiocytoma. Methods Several excisional full-thickness biopsies of trunk were perfomed,examined under light microscopy and electroric microscopy. Results Histopathologic evaluation revealed a well-demarcated nodule arising from the trunk that contained a storiform array of spindle cells admixed with numerous multinucleated giant cells,foamy histiocytes and histiocytes. Sudan black stains done on frozen tissue confirmed the presence of fat in areas of foamy histiocytes. The spindle cells, foamy histiocytes and histiocytes were labeled with antibodies to CD68 and lysozyme. On ultrastructural examination,Birbeck's granules and Caputo bodies were not found. Conclusion Progressive nodular histiocytoma is distinguished with juvenile xanthogranuloma, reticulohistiocytoma, eruptive histiocytoma and xanthoma disseminatum.