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成人临床表现不典型丛状血管瘤2例OA

Two cases of atypical adult tufted angioma

中文摘要英文摘要

报告2例成人临床表现不典型丛状血管瘤.患者1,男,41岁,颈部疼痛性红色斑块2年.皮肤科检查:颈部散在分布红色斑块,最大面积约7 cm × 3.5 cm,上覆簇性暗红色丘疹,质韧,部分呈假性水疱样损害.实验室检查:血小板83 × 109/L;凝血功能异常.皮损组织病理:真皮及皮下组织见结节性内皮细胞呈丛状增生,似"炮弹样"外观.免疫组化:CD31、CD34阳性,D2-40局灶阳性.诊断:丛状血管瘤.治疗:建议口服普萘洛尔,患者拒绝,随访观察.患者2,女,30岁,左足背褐色结节伴痛痒2月余.皮肤科检查:左足背分布一直径约0.8 cm的褐色结节,质硬,表面粗糙.实验室检查:血常规、凝血功能正常;IgG 23.70 g/L,C3 0.888 g/L;ANA 1∶640(+).皮损组织病理:真皮见内皮细胞排列致密,呈丛状增生.免疫组化:CD31、CD34阳性,D2-40局灶阳性.诊断:丛状血管瘤.予手术切除,术后随访一年,无复发.

We report two cases of tufted angioma with atypical clinical presentations in adults.Patient 1 was a 41-year-old male with painful red plaques on his neck for 2 years.Cutaneous ex-amination showed dark red papules distributed in clusters on the red plaques(7 cm × 3.5 cm in size)of the neck,tough texture and some pseudo-vesicular lesions.Laboratory tests revealed a platelet(PLT)count of 83 × 109/L and abnormal coagulation.Histopathology revealed nodular endothelial cell hyperplasia arranged in tufts and looked like"cannonball"appearance in the der-mis and subcutaneous tissue.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally positive.Diagnosis:Tufted angioma.The patient refused the treatment with oral propranolol,but was still under follow-up.Patient 2 was a 30-year-old female with a brown nodule on the left dorsal foot,accompanied by pruritus and pain for over two months.Dermatologi-cal examination showed a brown nodule in a diameter of about 0.8 cm,with a hard and rough sur-face.Laboratory tests were normal in routine blood test,liver,kidney and coagulation functions,except elevations in IgG(23.70 g/L)and C3(0.888 g/L),and ANA 1∶640(+).Histopatho-logical analysis revealed compact arrangement of endothelial cells with tuft proliferation in the der-mis.Immunohistochemical stainings of CD31 and CD34 were positive,and D2-40 was focally pos-itive.Diagnosis was tufted angioma.Surgical resection was given.

杨娈;于晓静;孙青

山东大学齐鲁医院,山东 济南 250012山东大学齐鲁医院,山东 济南 250012山东大学齐鲁医院,山东 济南 250012

丛状血管瘤鉴别诊断卡梅现象治疗

tufted angiomadifferential diagnosisKasabach-Merritt phenomenontreatment

《皮肤性病诊疗学杂志》 2024 (2)

113-117,5

10.3969/j.issn.1674-8468.2024.02.008

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