摘要:

The light-microscopic recognition of patch/plaque stages of mycosis fungoides is difficult, but remains as the “gold standard” for the diagnosis of mycosis fungoides (MF). A review of previous publications concerning the light-microscopic histological criteria for recognition of MF is followed by a summary of our recent histological findings involving 100 patients. The quantitative histological assessment included 13 different parameters for each case of patch/plaque-stage disease. The different criteria included parakeratosis, acanthosis, density of upper dermal mononuclear cell infiltrate, degree of lymphocyte atypia, degree of epidermotropism, Pautrier microabscess formation, band-like pattern, presence of basal vacuolar change, spongiosis, papillary dermal fibrosis, presence of eosinophils, and presence of plasma cells. The most significant histological features of patch/plaque-stage MF are:Broad zones of epidermis in which lymphocytes, which are usually not markedly atypical, are in close apposition to basal and lower-level keratinocytes predominantly as single cells in a somewhat linear configuration on the epidermal side of the dermal-epidermal junction. In general, the surrounding keratinocytes do not display any cytopathic changes, i.e., basal vacuolar degeneration or apoptosis.The papillary dermis contains a variably dense mononuclear cell infiltrate that is usually polymorphous and in which there is papillary dermal fibrosis with plasma cells and eosinophils.Pautrier microabscesses are only present in the minority of cases of MF.Representative “threshold” cases of the earliest recognizable diagnostic cases of MF are illustrated. A pragmatic diagnostic approach to patients presenting with a clinical picture suggesting MF is outlined. The potential usefulness of additional ancillary diagnostic techniques such as immunoperoxidase frozen-section stains and T-cell-receptor gene rearrangements are briefly reviewed.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The present report describes two patients with alopecia mucinosa who developed mycosis fungoides 4 and 8 years after the diagnosis of alopecia mucinosa had been made. The relationship between both conditions will be discussed.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This report describes the clinical and pathological features of cutaneous lesions observed in a 73-year-old woman with terminal adult T-cell leukemia/lymphoma (ATLL) and a 42-year-old man who had chronic ATLL with persistent nasal stuffiness and rhinorrhea of 2 years' duration. Histology of the skin lesions from these two cases showed large blood vessel (arterial and venous) involvement at the level of the dermosubcutaneous junction, in which angiocentric and angiodestructive infiltration of the tumor cells was prominent and reminiscent of lymphomatoid granulomatosis (LYG) and/or polymorphic reticulosis. ATLL commonly involves the skin. Moreover, it may originate in the skin. The majority of researchers have observed perivascular and periadnexal infiltration, frequent epidermal exocytosis with Pautrier's microabscesses, and the occasional presence of leukemic cells within the vascular lumen; however, vascular involvement like that seen in our cases has not been described before. Our cases suggest that a variety of T-cell malignancies may be angiocentric and angiodestructive in nature, and that so-called LYG and LYG-like malignant lymphomas are not a single disease, but may constitute a heterogeneous group of T-cell malignancies including ATLL.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Three cases of multicentric reticulohistiocytosis showing typical clinical, histologic, and ultrastructural findings are reported. In one, gastric cancer occurred; in the other two cases, severe polyarthritis was the only detectable internal involvement. The serine proteinases, urokinase and tissue-type plasminogen activator, were evaluated both with the autohistographic technique and spectrophotometric assay in lesional skin and synovia. Urokinase levels appeared grossly increased in the lesional synovia and moderately increased in the lesional skin. We suggest that urokinase, presumably released by the activated proliferating histiocytes, may play a major role in the extracellular matrix degradation leading to erosion of cartilage and adjacent bone in multicentric reticulohistiocytosis.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Myofibroblasts abound in granulation tissue, where they play an important role in the healing process. We evaluated the characteristics of fibroblasts in ten patients with keloids, a disorder of skin wound repair. Keloid lesions uniformly exhibited numerous fibroblasts with prominent Golgi complexes and abundant rough endoplasmic reticulum. Although rare fibroblasts exhibited a convoluted nucleus and tangled microfilaments, none could be characterized as myofibroblast, as defined by cytoplasmic myofilaments and cell to cell junctions. We conclude that fibroblast density and activity are increased in keloids, but true myofibroblasts are not a component of these lesions.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Three unusual cases of basal cell carcinoma showing matrical differentiation as evidenced by the focal presence of “shadow cells” within basaloid islands are described. The termbasal cell tumor with matrical differentiationseems to be appropriate for this type of tumor. Its differentiation from other tumors, particularly malignant pilomatricoma, is also discussed.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The clinical and histological appearances of four cases of idiopathic atrophy of the nails are described. The findings do not support previous contentions that lichen planus is the underlying pathological process.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We report the development of a lymphoproliferative reaction in the red areas of a tattoo in a 53-year-old man. The results of histologic and immunohistochemical studies were consistent with a diagnosis of lymphadenosis benigna cutis. Patch tests showed a strong, delayed-type hypersensitivity to several mercury products. The pathogenetic mechanisms operative in the development of this reaction are discussed.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A 39-year-old woman who had cryptogenic cirrhosis and who had received two liver transplants developed necrotic skin lesions over the chest, upper arms, and thighs. Biopsy showed enlarged endothelial cells with intranuclear and intracytoplasmic inclusions characteristic of cytomegalovirus (CMV) infection. However, a few multi-nucleated gaint cells were observed beneath a necrotic epidermis. This, combined with the clinical presentation, suggested to infectious disease consultants an infection with herpes simplex virus. Using the immunoperoxidase technique, inclusions stained positively with antibody to CMV and showed a negative reaction for herpes simplex antigen. In situ hybridization using biotinylated DNA probes on formalin-fixed, paraffin-embedded tissue sections confirmed the diagnosis of CMV infection and failed to substantiate infection with herpes simplex virus. Subsequently, blood cultures became positive for CMV. The early recognition of CMV infection in the skin permitted institution of antiviral therapy with gancyclovir. Specific skin lesions of CMV infection are likely to be encountered with increasing frequency among immunosuppressed patients. Lesions may be vesicular, and epidermal multinucleated giant cells can occasionally be identified. In situ hybridization is a technique that is readily adaptable to surgical pathology laboratories and permits both a rapid, specific diagnosis and the early institution of appropriate therapy.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The metaplastic synovial cyst (synovial metaplasia of the skin) is a recently described intradermal cyst lined by a membrane that resembles hyperplastic synovium. All of the reported cases thus far have occurred in adults after surgical incision. A case of metaplastic synovial cyst after partial excision of nevus sebaceus in a 7-year-old girl is herein reported. Pathogenesis and light-microscopic and immunohistochemical features of this case are discussed.

ISSN:0193-1091    

出版商:OVID    

年代:1988

数据来源: OVID