经典型Kaposi肉瘤合并获得性反应性穿通性胶原病一例  

A case of Kaposi’s sarcoma with acquired reactive penetrating collagenosis

作　　者：朱建建[1] 李昕[1] 陈霄霄 袁佳 龙剑[1] 何平[1] 杜维[2] ZHU Jian-jian;LI xin;CHEN Xiao-xiao(Department of Dermatology,the First Peoples Hospital of Changde City in Hunan Province,Changde 415000,China)

机构地区：[1]湖南省常德市第一人民医院皮肤科,415000 [2]常德市第一人民医院病理科

出　　处：《实用皮肤病学杂志》2021年第4期253-256,共4页Journal of Practical Dermatology

基　　金：湖南省科技创新计划项目(2017SK51301)。

摘　　要：56岁老年男性,全身红斑、丘疹伴瘙痒1年余,四肢及外阴紫红斑8个月,加重伴肿胀2个月。阴囊及左小腿紫红斑组织病理示:真皮内梭形细胞团块样增生,纵横交错排列,瘤细胞有异形性,偶见核分裂像,梭形细胞团块中见裂隙样腔隙结构,梭形细胞间可见红细胞外渗,含铁血黄素沉积以及间质内可见慢性炎性细胞浸润。免疫组化染色显示梭形细胞CD31、CD34、HHV8阳性,D2-40部分阳性、caldesmon阴性;核增殖相关抗原(Ki-67)约10%阳性。背部红斑组织病理示:表皮中央凹陷,内含角质物、淋巴细胞及变性的胶原,两侧可见角化不全及棘层稍增厚,其下方真皮内可见变性的胶原穿向表皮,Masson染色示蓝色胶原纤维穿出表皮。诊断:(1)经典型Kaposi肉瘤;(2)获得性反应性穿通性胶原病。A 56-year-old male patient presented with erythema and papules over the whole body with pruritus for more than one year, furthermore with purple erythema of the external genitals and limbs for eight months, aggravating with edema for two months. Histopathological examination of the erythema on his scrotum and left leg showed that there were masses of spindle cells infiltrated in dermis, the cells crisscross arranged with certain pleomorphism and occasionally mitosis;there were fissure-like cavity structures in the masses with erythrocytes extravasation;hemosiderin deposition among the spindle cells and infiltration of chronic inflammatory cells in the stroma. Immunopathology showed the tumor cells expressed CD31, CD34, HHV-8, partly expressed D2-40, didn’t express caldesmon, and Ki-67 positive cells were about 10%. Histopathological examination of the erythema on his back showed that there was a depression in the center of the epidermis containing keratin, lymphocytes and degenerated collagen. On the lateral sides of the depression, there was parakeratosis and slight acanthosis. In the dermis, there was degenerated collagen penetrating into the epidermis, and Masson staining showed blue collagen fibers penetrating into the epidermis. The diagnosis considered: classical Kaposi’s sarcoma with acquired reactive penetrating collagenosis.

关 键 词：KAPOSI肉瘤 反应性穿通性胶原病 获得性 

分 类 号：R739.5[医药卫生—肿瘤]