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误诊为血管瘤的Spitz痣1例OA

A case of Spitz nevus was misdiagnosed as hemangioma

中文摘要英文摘要

报告1例Spitz痣.患者女,5岁,因面部红色皮损3个月就诊.患者3个月前面部出现米粒大小红色肿物,曾于外院诊断为血管瘤,行脉冲染料激光治疗后出现水疱,水疱干涸后红色肿物迅速隆起、增多,基底红斑明显增大.皮肤科检查:面部可见一约1.5 cm × 1.0 cm境界清晰的淡红色斑片,其上可见散在多个红色球状肿物,米粒至绿豆大小,表面光滑,无破溃,压之稍褪色.皮损组织病理检查:镜下呈混合痣图像,痣细胞包括梭形细胞及上皮样细胞,梭形细胞核大,核仁明显,细胞增生活跃,上皮样细胞呈多角形,边界较清晰,黑素细胞周围可见裂隙.免疫组化:HMB45(+)、MelanA(+)、CD31(-)、CD34(-)、Ki-67约10%(+).诊断:Spitz痣.行手术完整切除,术后2周,皮损愈合良好.随访未见新发皮损.

A case of Spitz nevus is reported.A 5-year-old girl was diagnosed with hemangioma because of a 3-month history of red lesions on her right face.Following the treatment with pulse dye laser,blisters appeared.After the blisters dried up,the red masses rapidly elevated with in-crease in number over the enlarged erythema.Dermatological examination showed a demarcated erythema about 1.5 cm ×1.0 cm on the face,on which there were multiple red spherical masses,sized rice grain to mung bean,with smooth surface.The masses slightly faded under pressure.Pa-thology of skin lesions showed mixed nevus.Nevus cells included spindle cells and epithelioid cells,with large spindle nuclei,obvious nucleoli,and active cell proliferation.Epithelioid cells were polygonal with clear boundaries,and visible fissures around melanocytes.Immunohistochem-istry showed positive for HMB45 and Melan A,and negative for CD31 and CD34,Ki-67 about 10%positive.The diagnosis was Spitz nevus.Two weeks after the resection,the skin healed well,and no new skin lesions were found during the follow-up.

吴颖烨;王莹;刘欣欣;李钦峰

天津市儿童医院(天津大学儿童医院),天津市儿科研究所,天津市儿童出生缺陷防治重点实验室,天津 300074天津市儿童医院(天津大学儿童医院),天津市儿科研究所,天津市儿童出生缺陷防治重点实验室,天津 300074天津市儿童医院(天津大学儿童医院),天津市儿科研究所,天津市儿童出生缺陷防治重点实验室,天津 300074天津市儿童医院(天津大学儿童医院),天津市儿科研究所,天津市儿童出生缺陷防治重点实验室,天津 300074

Spitz痣血管瘤

Spitz nevushemangioma

《皮肤性病诊疗学杂志》 2024 (12)

850-853,4

天津市医学重点学科(专科)建设项目(TJYXZDXK-040A)

10.3969/j.issn.1674-8468.2024.12.008

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