对石蜡包埋的皮肤组织做利什曼原虫特异性PCR发现罕见的皮肤利什曼病组织病理学特征  

Unusual histopathological features of cutaneous leishmaniasis identified by polymerase chain reaction specific for Leishmania on paraffin-embedded skin biopsies

作　　者：Ber A. Bldorn-Schlicht N. Wiebels D. 周少娜 

机构地区：[1]Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg, Germany

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第12期16-17,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Background: Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. Objectives: To identify manifestations of CL that may escape diagnosis. Methods: Correlation of clinical diagnosis and histopathological findings in 28 biopsy specimens taken from 19 patients with CL confirmed by polymerase chain reaction (PCR) specific for Leishmania. Results: In only one patient was the clinical diagnosis CL; other diagnoses included: malignant epithelial neoplasms (5), follicular cyst (2), atypical mycobacteriosis (1), sarcoidosis (2) and lymphoma (1). Lesions were single (15) or few (4) nodules predominantly situated on the extremities or face (16). Histopathological findings were diagnostic of CL in only 10 cases. In nine cases Leishmania was not identified microscopically; histopathological diagnoses were: granulomatous dermatitis (6), lupoid rosacea (1), foreign body granuloma (1) and granuloma annulare (1). Unaltered epidermis (9), nodular infiltrates (5), numerous multinucleated histiocytes (3), palisaded granulomas with fibrinoid centres (2), sarcoidal granulomas (4) and elastophagocytosis (1) misled the histopathologists in these cases. Conclusions: CL seems often to be misdiagnosed clinically in countries where it is not endemic. Histopathologically, CL may be misinterpreted as sarcoidosis, foreign body granuloma, lupoid rosacea and granuloma annulare, especially when Leishmania is not seen microscopically. We suggest that in Northern Europe, PCR for Leishmania-specific DNA should be performed routinely in any granulomatous dermatitis presenting as a single or few nodules on the extremities or face, even when a diagnosis of CL was not considered by the referring clinician.Background: Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. Objectives: To identify manifestations of CL that may escape diagnosis. Methods: Correlation of clinical diagnosis and histopathological findings in 28 biopsy specimens taken from 19 patients with CL confirmed by polymerase chain reaction (PCR) specific for Leishmania. Results: In only one patient was the clinical diagnosis CL; other diagnoses included: malignant epith...

关 键 词：皮肤利什曼病 组织病理学 东方疖 病理组织学 组织学 利什曼氏原虫 PCR 

分 类 号：R757[医药卫生—皮肤病学与性病学]