成人临床表现不典型丛状血管瘤2例  

Two cases of atypical adult tufted angioma

作　　者：杨娈 于晓静[1] 孙青[1] YANG Luan;YU Xiaojing;SUN Qing(Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《皮肤性病诊疗学杂志》2024年第2期113-117,共5页Journal of Diagnosis and Therapy on Dermato-venereology

摘　　要：报告2例成人临床表现不典型丛状血管瘤。患者1,男,41岁,颈部疼痛性红色斑块2年。皮肤科检查:颈部散在分布红色斑块,最大面积约7 cm×3.5 cm,上覆簇性暗红色丘疹,质韧,部分呈假性水疱样损害。实验室检查:血小板83×10^(9)/L;凝血功能异常。皮损组织病理:真皮及皮下组织见结节性内皮细胞呈丛状增生,似“炮弹样”外观。免疫组化:CD31、CD34阳性,D2-40局灶阳性。诊断:丛状血管瘤。治疗:建议口服普萘洛尔,患者拒绝,随访观察。患者2,女,30岁,左足背褐色结节伴痛痒2月余。皮肤科检查:左足背分布一直径约0.8 cm的褐色结节,质硬,表面粗糙。实验室检查:血常规、凝血功能正常;IgG 23.70 g/L,C30.888 g/L;ANA 1∶640(+)。皮损组织病理:真皮见内皮细胞排列致密,呈丛状增生。免疫组化:CD31、CD34阳性,D2-40局灶阳性。诊断:丛状血管瘤。予手术切除,术后随访一年,无复发。We report two cases of tufted angioma with atypical clinical presentations in adults.Patient 1 was a 41-year-old male with painful red plaques on his neck for 2 years.Cutaneous examination showed dark red papules distributed in clusters on the red plaques(7 cm×3.5 cm in size)of the neck,tough texture and some pseudo-vesicular lesions.Laboratory tests revealed a platelet(PLT)count of 83×10^(9)/L and abnormal coagulation.Histopathology revealed nodular endothelial cell hyperplasia arranged in tufts and looked like“cannonball”appearance in the dermis and subcutaneous tissue.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally positive.Diagnosis:Tufted angioma.The patient refused the treatment with oral propranolol,but was still under follow-up.Patient 2 was a 30-year-old female with a brown nodule on the left dorsal foot,accompanied by pruritus and pain for over two months.Dermatological examination showed a brown nodule in a diameter of about 0.8 cm,with a hard and rough surface.Laboratory tests were normal in routine blood test,liver,kidney and coagulation functions,except elevations in IgG(23.70 g/L)and C3(0.888 g/L),and ANA 1∶640(+).Histopathological analysis revealed compact arrangement of endothelial cells with tuft proliferation in the dermis.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally positive.Diagnosis was tufted angioma.Surgical resection was given.

关 键 词：丛状血管瘤 鉴别诊断 卡梅现象 治疗 

分 类 号：R732.2[医药卫生—肿瘤]