未定类细胞性组织细胞增生症误诊1例  

Clinical Misdiagnosis of A Case with Blastic Plasmacytoid Dendritic Cell Neoplasm

作　　者：李乐[1] 吕怀盛[2] 夏莉[1] 张岩[3] 黑静雅[2] 高琼[1] 施惠娟[1] 张晓鸣[1] 葛新红[1] 

机构地区：[1]宁夏医科大学附属总院皮肤科,宁夏银川750004 [2]宁夏医科大学附属总院病理科,宁夏银川750004 [3]宁夏医科大学电镜室,宁夏银川750004

出　　处：《中国皮肤性病学杂志》2014年第8期864-866,872,共4页The Chinese Journal of Dermatovenereology

摘　　要：患者女，58岁。双上肢、腰背部皮疹3年余，加重并泛发全身结节1年。体检：头皮、颜面、颈部、躯干、双上肢可见密集分布的直径O．5～3．Ocm大小不规则的暗红色浸润性斑块、隆起性结节、边界尚清楚，质地较韧，无触痛。皮损组织病理检查（胸部）：表皮除角质层外整个受累，真皮全层及部分脂肪组织弥漫分布单个核细胞浸润，胞质淡染，胞核圆形、不规则或分叶状，部分细胞可见核沟，核仁不明显，核分裂相罕见。免疫组织化学：CDla（＋），S100（＋），cD68（＋）。电镜检查未找到Birbeck颗粒。诊断：未定类细胞性组织细胞增生症。A 58-year-old female presented with a 3-year history of rashes on upper limbs and lower back and a l-year history of nodules spreading the whole body. Physical examination revealed dark red, irregular, infiltrative plaques and protuberant nodules sized from 0.5cm to 3.0cm in diameter on the scalp, face, neck, trunk and upper limbs. The lesions were with clear margin, firm texture and painlessness. Histopathological ex- amination revealed diffuse infiltration of mononuclear ceils in the dermis and subdermal fat tissue. Infiltra- ted cells were characterized by lightly stained cytoplasm, and circular, irregular or lobulated nuclei. Nuclear grooves could be seen in part of the cells,prominent nucleoli were not seen, and seldom mitotic cells. Im- munohistochemistry showed CDla（ ＋ ） ,S100（ ＋ ） ,and CD68（ ＋ ）. Birbeck granule was not observed un- der electron microscopy. Diagnosis： indeterminate cell histiocytosis.

关 键 词：组织细胞增生症 未定类细胞 误诊 

分 类 号：R733.1[医药卫生—肿瘤]