乳房外Paget病的共聚焦激光扫描显微镜影像学观察  

Imaging observation of extramammary Paget disease with confocal laser scanning microscopy

作　　者：后桂荣[1] 肖玉娟[1] 曾抗[1] 

机构地区：[1]南方医科大学南方医院皮肤科,广东广州510515

出　　处：《临床皮肤科杂志》2015年第11期746-749,共4页Journal of Clinical Dermatology

摘　　要：目的:以组织病理为对照,探讨乳房外Paget病(EMPD)的共聚焦激光扫描显微镜(CLSM)的影像学表现。方法:选取经临床及组织病理诊断为EMPD的患者6例,应用CLSM观察患者的皮损及其周围2 cm的细胞图像,记录多处图像,对CLSM疑似病变处行皮肤病理活检,进行对比分析。结果:6例EMPD的临床特征表现为红斑鳞屑、浸润性、边界清楚的"湿疹样"皮损。CLSM表现为表皮全层可见高折光核大异型细胞结构,大小约为正常角质形成细胞的2倍或更大,核中等亮度,细胞质折光度较低。高折光度区域亦可见有丝分裂象的"树枝状"细胞。皮损组织病理检查示胞体较大,胞质丰富,核大呈泡状的细胞。表皮的Paget细胞和表皮、真皮交界处的Paget细胞巢为特征性表现。与组织病理所见一致。结论:CLSM图像下,EMPD的典型表现可为该病的无创性辅助诊断、随访和筛查提供帮助。Objective： To investigate the microscope features of extramammary Paget disease （EMPD） using in vivo confocal laser scanning microscopy （CLSM） compared with histopathology. Methods： Six patients with EMPD were enrolled in this study between January 2010 and December 2012. EMPD skin lesions and perilesional normal skin within 2 cm from the lesions were examined using CLSM and subjected to histopathological examination. Results： The clinical features of EMPD included erythema, scale, erosion, exudation, and demarcated eczematoid lesions. CLSM showed atypical cellular structures with high refraction and large nucleus （≥12 times of normal keratinocytes）, medium bright nucleus and dark cytoplasm throughout the epidermis. Mitotic dendritic cells were observed in high refractive region. These features were consistent with histopathological findings, which showed large cells, abundant cytoplasm and vacuolar nucleus. Conclusion： CLSM may be used as a non-invasive auxiliary tool for the diagnosis, follow-up and screening of EMPD.

关 键 词：Paget病 乳房外 显微镜 共聚焦激光扫描 

分 类 号：R739.5[医药卫生—肿瘤]