摘要
目的观察斑片期蕈样肉芽肿患者皮损的在体反射式共聚焦显微镜(RCM)下图像特征,探讨RCM在初筛早期蕈样肉芽肿的临床应用价值。方法回顾性分析50例临床初步诊断为斑片期蕈样肉芽肿的患者进行RCM多层扫描,观察镜下特征;RCM扫描部位进一步进行组织病理检查,组织病理确诊斑片期蕈样肉芽肿41例。结果1.斑片期蕈样肉芽肿RCM主要特征为:(1)表皮内单个或聚集分布的卵圆形或圆形中等折光的异型单一核细胞、核明亮呈多角形、核周可伴弱折光空晕;(2)真表皮交界处、真皮乳头可见单一核细胞浸润;(3)真皮乳头胶原纤维增粗、折光增强。2.RCM诊断符合病理诊断。结论斑片期蕈样肉芽肿皮损在RCM图像下具有较特异的特点,RCM诊断与病理诊断有较好的一致性,因此结合临床表现RCM可以为斑片期蕈样肉芽肿诊断或鉴别诊断提供线索,是组织病理学检查的有益补充。
Objective To observe the image characteristics of skin lesions of patients with mycosis fungoides in plaque stage under vivo reflection confocal microscopy(RCM),and to explore the clinical application value of RCM in screening early mycosis fungoides.Methods Retrospective analysis of 50 cases of clinically initially diagnosed as mycosis fungoides plaque stage,RCM multi-slice scanning,observation of microscopic features;RCM scanning site further histopathological examination,histopathology confirmed 41 cases of plaque stage mycosis fungoides.Results 1.The main characteristics of RCM in patch stage mycosis fungoides were as follows:(1)Single or aggregated oval or round heterotypic mononuclear cells with moderate refraction in the epidermis.The nuclei were bright and polygonal,with weak refraction halo around the nucleus;(2)Mononuclear cells infiltrated at the junction of the true epidermis and dermal papilla;(3)Collagen fibers of dermal papilla were thickened and refracted.2.RCM diagnosis was consistent with pathological diagnosis.Conclusions The lesions of mycosis fungoides in plaque stage have specific characteristics under RCM images,and the diagnosis of RCM is consistent with pathological diagnosis.Therefore,combined with clinical manifestations,RCM can provide clues for the diagnosis or differential diagnosis of mycosis fungoides in plaque stage,which is a beneficial supplement to histopathological examination.
作者
于世荣
王朋
康晓静
普雄明
YU Shirong;WANG Peng;KANG Xiaojing;PU Xiongming(Xinjang Key Laboratory of Dermatology,People's Hoxpital of Xinjiang Uygur Autonomous Region(XJYS1707),Urumqi,830011,China;Graduate School of Xinjiang Medical University,Urumqi,830054,China)
出处
《新疆医学》
2020年第12期1245-1248,共4页
Xinjiang Medical Journal
基金
新疆维吾尔自治区人民医院院内项目(项目编号:20160104)
新疆维吾尔自治区自然科学基金(项目编号:2016D01C119)。
关键词
反射式共聚焦显微镜
蕈样肉芽肿
斑片期
早期诊断
Reflective Confocal Microscopy
Mycosis Fungoides
Plaque Stage
Early Diagnosis
