靶样含铁血黄素沉积性血管瘤的皮肤镜和RCM观察与临床应用  

Observation and clinical application of dermoscopy and RCM for THH

作　　者：刘海军[1] 孟如松[1] 胡博[1] 杨世飞[1] 李艺鹏 

机构地区：[1]全军皮肤病研究所空军总医院皮肤病医院皮肤病影像诊断中心,北京100142

出　　处：《中国体视学与图像分析》2017年第1期31-36,共6页Chinese Journal of Stereology and Image Analysis

基　　金：国家自然科学基金(61027004;61271436)

摘　　要：目的探讨临床上靶样含铁血黄素沉积性血管瘤(THH)在偏振光皮肤镜(PD)与反射式共聚焦激光扫描显微镜(RCM)下特征。方法对2015年1月至2017年1月来我院就诊73例患者的检查结果及病理资料进行回顾性统计分析。结果 73例患者中皮肤镜下均显示多个圆形至椭圆形结构的深色腔隙,其中56例患者皮周伴有紫红色淤血斑(晕),仅有2例皮损中心与紫红色淤血斑(晕)两者间的皮肤为淡黄褐色,从而显现出由三种颜色形成的靶样外观;RCM显示角化过度,棘层增生、肥厚,真皮乳头下见较多扩张的网眼状分布的较大腔隙。2例患者组织病理均具有真皮浅层可见增生的薄壁大腔的血管,扩张充血,真皮内增生的薄壁血管部位有程度不同的含铁血黄素沉积。结论临床不典型的THH表现较易混淆、误诊,而本文皮肤镜与RCM观察结果与组织病理诊断结果有较好的一致性,同时对减少盲目活检、有效指导手术切除范围及选择恰当的治疗方法以及对于本病只依赖于手术活检才能与色素痣、黑素瘤、色素性基底细胞癌等疾病相鉴别,在临床上具有一定意义。Objective To investigate the clinical targetoid hemosiderotic hemangioma（THH） in polarized light dermoscopy（PD） and reflective confocal laser scanning microscopy（RCM） features. Methods from January 2015 to January 2017 in our hospital 73 patients test. Results and pathology were retrospectivelyanalyzed. Results In 73 cases of skin under the microscope showed a dark lacuna round to oval structure,of which 56 weeks with blood stasis purple skin,only 2 cases of lesions with purple red blood center,the skin is pale yellow brown,thus showing the target sample formed by three kinds of color appearance; RCM showed hyperkeratosis,acanthosis hyperplasia,hypertrophy,dermal papilla seen under more expansion of the mesh distribution of large. 2 patients with pathological lacuna have epidermis hyperplasia of large thinwalled cavity vascular dilatation and congestion,dermal growth There are different degree of hemosiderin deposition of thin vascular site students. Conclusion the THH findings of atypical clinical features are easily confused,and the misdiagnosis,dermoscopy and RCM observation results and pathological diagnosis results are in good agreement,at the same time to reduce the blind biopsy,effective treatment guide resection range and choose appropriate and for this disease depends only on surgical biopsy and to pigmented nevus,melanoma,pigmented basal cell carcinoma and other diseases identification has a certain significance in clinical application.

关 键 词：皮肤镜 共聚焦激光显微镜 血管瘤 靶样 含铁血黄素沉积性 

分 类 号：R739.5[医药卫生—肿瘤]