摘要
目的 探讨皮肤浆细胞增多症临床和组织病理表现。方法 对7例皮肤浆细胞增多症进行临床病理分析。结果 7例患者中女2例，男5例，平均年龄42.4岁，病程2 ~ 10年。临床表现为缓慢进展、多发的棕色斑片及斑块。7例患者血尿粪常规、心电图和腹部B超等检查未见异常。3例行血清IgG检测，均高于参考值。2例做骨髓细胞学检查，浆细胞比例增高占5％，以成熟浆细胞为主。7例皮损组织病理：表皮基底层色素增加，真皮血管周围见以淋巴细胞、成熟浆细胞为主的浸润。免疫组化结果示，7例κ和λ轻链表达比例均近似1∶1，IgG均为强阳性表达，1例个别浆细胞IgG4阳性，6例IgG4阴性。结论 皮肤浆细胞增多症病因不明，有独特的临床及病理表现。
Objective To investigate clinical and histopathological manifestations of cutaneous plasmacytosis. Methods The clinical and histopathological data were collected from 7 cases of cutaneous plasmacytosis and analyzed retrospectively. Results Of the 7 patients, 2 were female, and 5 were male. The average age was 42.4 years, and the duration of disease ranged from 2 to 10 years. All the 7 patients presented with multiple slow progressive brown patches and plaques. No abnormality was observed in routine examinations of blood, urine and faeces, electrocardiogram and abdominal ultrasonography in the 7 patients. Three patients underwent serum IgG detection, and their serum levels of IgG were all higher than reference values. Two patients were subjected to cytological examination of bone marrow, which showed the percentage of plasma cells （mainly mature plasma cells） was up to 5%. Histopathological examination of 7 cases showed pigmentation in the basal layer of the epidermis, and infiltration mainly consisting of lymphocytes and mature plasma cells around the blood vessels in the dermis. Immunohistochemical study revealed that the ratio of κ to λ light chain was approximately 1∶1, and the plasma cells were strongly positive for IgG. IgG4 was positive in very few plasma cells in 1 case, and negative in the other 6 cases. Conclusion The etiology of cutaneous plasmacytosis is still unclear, but it has characteristic clinical and histopathological manifestations.
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2017年第12期914-916,共3页
Chinese Journal of Dermatology
