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目的探讨获得性弹性组织变性血管瘤(AEH)的临床表现、病理学特点及诊断,提高对本病的认识。方法分析1例AEH的临床表现、组织病理、特殊染色及免疫组化,复习相关文献并进行讨论。结果患者腹部皮损缓慢增大不伴痛痒2年余。皮肤科情况:腹部一约4.5cm×2.5cm近长条形紫罗兰色浸润性斑块,境界清楚,压之不退色。皮损组织病理示:表皮棘层肥厚,皮突延长,真皮浅层可见毛细血管带状增生,与表皮平行,与表皮之间有狭窄的无浸润带,部分血管内皮细胞呈鞋钉样突出至管腔,未见不典型性,血管周围真皮弹性组织变性;Verhoeff-Van Gieson染色示:增生血管周围弹力纤维明显减少,可见断裂、颗粒状碎裂;免疫组化染色示:内皮细胞CD31,CD34阳性,周细胞SMA阳性,HHV-8,D2-40阴性,Ki-67<1%。符合AEH。结论 AEH国内尚未见报道,国外罕有报道。组织病理、特殊染色及免疫组化对本病的诊断及鉴别诊断有重要作用。
Objective To investigate the clinical manifestations, pathological features and diagnosis of acquired elastotic hemangiomas (AEH) and to improve their understanding of the disease. Methods The clinical manifestations, histopathology, special staining and immunohistochemistry of one case of AEH were analyzed and the related literatures were reviewed and discussed. Results The patient’s skin lesions slowly increased without itching more than 2 years. Dermatology: Abdomen about 4.5cm × 2.5cm nearly strip-shaped violet infiltrative plaque, the realm of clear, the pressure does not fade. Pathological lesions showed: epidermal acanthosis, lenticel lengthening, superficial dermis visible capillaries hyperplasia, parallel with the epidermis, there is a narrow non-invasive zone between the epidermis, some of the vascular endothelial cells were spike-like to There was no typical atherosclerosis and degeneration of elastic tissue around the perivascular cells. The Verhoeff-Van Gieson staining showed that the elastic fibers around the hyperplastic vessels were significantly reduced, with rupture and granular disintegration. Immunohistochemical staining showed that the number of CD31 and CD34 Positive, pericyte SMA positive, HHV-8, D2-40 negative, Ki-67 <1%. Meet AEH. Conclusion AEH has not been reported in China and rarely reported abroad. Histopathology, special staining and immunohistochemistry play an important role in the diagnosis and differential diagnosis of this disease.