巨大环状皮肤肌纤维瘤  

Giant annular dermatomyofibroma

作　　者：罗素菊 

机构地区：[1]Yaumatei Dermatological Clinic, 143 Battery Street, Kowloon, Hong Kong

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第3期60-61,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：A 74-year-old lady presented with a painful giant annular abdominal plaque for a duration of 2 years. The plaque developed from a cholecystectomy scar and extended peripherally around it. The patient had had a cholecystectomy for gallstones 10 years previously. She was a diabetic on oral hypoglycaemic agents and had no history of radiotherapy. Physical examination showed a tender well-demarcated annular erythermatous keloid-like plaque, measuring 13 cm × 15 cm, surrounding a cholecystectomy scar. Another smaller oval plaque, measuring 3 cm× 2 cm, was found on the left side of the abdomen (Fig. 1). The initial clinical diagnosis was dermatofibrosarcoma protuberan (DFSP).Adeep incisional biopsy including subcutaneous fatwas performed under local anesthesia for pathological examination. Histologically, there was a plaque-like lesion involving the upper reticular dermis but not extending to the subcutaneous fat. The lesion showed proliferation of spindle-shaped cells arranged in intersecting fascicles and appeared parallel to the skin surface. Only a vague storiform pattern was seen at the edges. The cells had relatively uniform elongated nuclei and mitosis was not seen. The overlying epidermis showed mild hyperplasia with pigmentation of the basal layer (Fig. 2). Smoothmuscle actinwas positive (Fig. 3), desminwas negative and CD34 was negative. The final diagnosis was dermatomyofibroma (DMF). Extra-abdominal fibromatosis was unlikely because broad elongated fascicles among collagenous stroma were not evident, while intersecting fascicles parallel to the skin surface were typical of DMF. The smaller plaque on her left abdomen was excised and gave similar histological and staining results. The giant annular plaque was not excised as the patient refused further surgery. She has since been closely monitored.A 74-year-old lady presented with a painful giant annular abdominal plaque for a duration of 2 years. The plaque developed from a cholecystectomy scar and extended peripherally around it. The patient had had a cholecystectomy for gallstones 10 years previously. She was a diabetic on oral hypoglycaemic agents and had no history of radiotherapy. Physical examination showed a tender well-demarcated annular erythermatous keloid-like plaque, measuring 13 cm × 15 cm, surrounding a cholecystectomy scar. Another smaller oval plaque, measuring 3 cm × 2 cm, was found on the left side of the abdomen （Fig. 1） . The initial clinical diagnosis was dermatofibrosarcoma protuberan （DFSP） . Adeep incisional biopsy including subcutaneous fatwas performed under local anesthesia for pathological examination.

关 键 词：腹部皮肤 肌纤维瘤 环状 巨大 胆囊切除术后 隆突性皮肤纤维肉瘤 女性患者 皮下脂肪 10年前 服降糖药 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学] R739.7[医药卫生—基础医学]