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來源資料
頁籤選單縮合
題名 | Histological Analysis of 10 Cases of Cutaneous Sarcoidosis in Taiwan=臺灣地區十例皮膚類肉瘤症之病理分析 |
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作者姓名(中文) | 蘇靜怡; 劉漢南; | 書刊名 | 中華皮膚科醫學雜誌 |
卷期 | 26:4 2008.12[民97.12] |
頁次 | 頁228-235 |
分類號 | 415.78 |
關鍵詞 | 皮膚科; 類肉瘤症; Cutaneous sarcoidosis; Granuloma; Granulomatous dermatitis; Taiwan; |
語文 | 英文(English) |
中文摘要 | 類肉瘤樣裸露的肉芽腫是類肉瘤症的典型病理表現,但非特有的表現。類肉瘤症也可能有其他的病理表現,而這些病理表現可能導致誤診。我們回顧十三例皮膚類肉瘤症之皮膚病理切片,診斷依據為皮膚或結膜的切片表現為無乾酪狀壞死的肉芽腫,典型的胸部X光表現,並排除其他可能的原因。所有的案例皆表現出類肉瘤樣裸露的肉芽腫,但有一位病患身上除了有類肉瘤樣裸露的肉芽腫的病灶,同時也有呈現結核樣肉芽腫的病灶。十二例的病理表現為肉芽腫散佈在真皮中,然而有一例呈現線型排列的肉芽腫。其他值得注意的病理表現包括膠原蛋白變性(6/13)、彈性纖維吞噬現象(1/13)、圍繞在神經周圍之線型肉芽腫(1/13)及黏液蛋白沉積(1/13)。所有案例皆未發現雙折光之異物。結核樣肉芽腫有時也會出現在類肉瘤症的病患上,若臨床上強烈懷疑是類肉瘤症時,可選擇另一病灶切片來找尋裸露的肉芽腫,幫助診斷。其他的病理表現,例如膠原蛋白變性、彈性纖維吞噬現象及圍繞在神經周圍之線型肉芽腫,則可能會導致誤診為環型肉芽腫、日光性肉芽腫及痲瘋。 |
英文摘要 | Naked sarcoidal granulomas are supposedly characteristic, but not pathognomonic of sarcoidosis. Other types of histopathological pattern can also happen in sarcoidosis and may lead to misdiagnosis. Thirteen archival skin specimens taken from 10 patients were retrieved from our file for study. All patients were labeled as sacroidosis based on histological evidence of noncaseating granuloma found in skin or conjunctival biopsies, characteristic chest x-ray findings, and lastly excluding other causes. All cases showed naked sarcoidal granulomas while additional tuberculoid granuloma was identifi ed in one case. Twelve biopsies showed multiple nodular infiltrates scattering in the dermis, but one biopsy revealed a leprosy-like linear granuloma. Other significant histological findings included collagen degeneration (6/13), elastophagocytosis (1/13), linear peri-neural granuloma (1/13), and mucin deposition (1/13). There were no birefringent foreign bodies identified in any biopsy. In conclusion, tuberculoid granulomas can occasionally happen in sarcoidosis. If sarcoidosis is strongly suspected in clinical settings, a second biopsy from different site to find naked granuloma is warranted. Other histologicalal findings, such as collagen degeneration, elastophagocytosis and linear peri-neural granuloma, may mislead us into diagnoses like granuloma annulare, actinic granuloma, and leprosy respectively. |
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