毛发上皮瘤的临床病理分析

发布时间：2018-08-04 15:38

【摘要】：目的：探讨毛发上皮瘤临床及病理学改变的特点,为诊治毛发上皮瘤提供科学的依据。方法：收集2000-2010年经我院确诊的18例毛发上皮瘤患者临床病例资料和病理学标本,其中男性7例,女性11例,发病年龄15岁-58岁,病程3个月-15年。采用4%甲醛溶液将所有病理标本固定,常规经过组织脱水后石蜡包埋、切片及HE染色,综合分析病理学改变及临床的特点。结果；18例毛发上皮瘤患者中,男性7例(占38.9%),女性11例(占61.1%),平均发病年龄37.2岁。本病主要表现为丘疹或结节,大部分患者没有自觉症状。10例皮损多发者,皮疹主要位于鼻唇沟两侧,对称分布,少数累及颈部或下眼睑；8例皮损单发者,分别分布在鼻背或鼻翼。通常幼年或青年时期为多发性毛发上皮瘤发病期,皮疹出现后并逐渐加重,呈肤色,淡黄色的半球形实性丘疹或小结节,直径一般在0.2-0.5cm。组织病理学改变主要是基底细胞样细胞增生,向毛囊及皮脂腺导管分化,可见大量基底样细胞成团分布,边缘基底样细胞成栅栏样排列,绕以明显的纤维母细胞及纤维性基质,部分切片内可见裂隙出现于结缔组织之间,有许多角囊肿和毛乳头样结构,有时在角化组织内可发现钙化。临床可误诊为黑痣、汗管瘤、基底细胞癌等。本研究收集的8例单发性毛发上皮瘤病例,均经过美容外科手术切除,经1年随访,7例无复发,1例继发鳞癌；10例多发性毛发上皮瘤采用超脉冲二氧化碳激光治疗,病例随访1年,无瘢痕、复发及恶变倾向。结论：①单发性毛发上皮瘤一般为直径0.5cm孤立结节,单靠临床表现很难确诊;多发性毛发上皮瘤多与遗传因素有关,多好发于鼻唇沟两侧、大小不等丘疹结节,直径0.2-0.5cm,必须依靠家族史及组织病理学检查确诊。②对于毛发上皮瘤患者可采用激光、手术等治疗手段。
[Abstract]:Objective: To investigate the clinical and pathological features of hair follicle epithelioma, and to provide scientific evidence for the diagnosis and treatment of hair epithelial tumor.
Methods: the clinical data and pathological specimens of 18 cases of hair epithelioma confirmed by our hospital for 2000-2010 years were collected, including 7 males and 11 females. The age of onset was 15 years old -58 years, and the course of disease was 3 months -15. All pathological specimens were fixed with 4% Formaldehyde Solution, and the paraffin embedded after dehydration, slice and HE staining, comprehensive analysis. Pathological changes and clinical characteristics.
Results: among the 18 cases of hair epithelioma, 7 cases (38.9%) were male (38.9%), 11 cases (61.1%), and the average age was 37.2 years old. The main manifestations were papules or nodules. Most patients had no conscious symptoms,.10 cases had multiple lesions. The rash was mainly located on both sides of the nasolabial groove, symmetrical distribution, a few of the neck or lower eyelids, and 8 cases with single lesions. In the onset of multiple hair epithelioma, usually in young or young age, after the occurrence of a rash and gradually aggravated, a skin color, a pale yellow hemispherical papule or small nodule, and the diameter of the 0.2-0.5cm. histologically is usually characterized by basal cell like cell proliferation and differentiation into the hair follicle and the sebaceous gland ducts. It can be seen that a large number of basal like cells are distributed in groups. The marginal basal like cells are arranged in a palisade like arrangement, around the obvious fibroblast and fibrous matrix, and the cracks appear in the connective tissue, with many angular cysts and hair papilla like structures. Sometimes calcification can be found in the keratinized group. Clinical misdiagnosis can be misdiagnosed as a black nevus and a sweat tube tumor. 8 cases of single hair epithelioma collected in this study were excised by cosmetic surgery and were followed up for 1 years, 7 cases had no recurrence, 1 cases of secondary squamous cell carcinoma, and 10 cases of multiple hair epithelioma were treated with hyperpulse carbon dioxide laser. The cases were followed up for 1 years, no scar, recurrence and malignant tendency.
Conclusion: (1) the solitary hair epithelioma is usually 0.5cm solitary nodule in diameter, which is difficult to diagnose by clinical manifestation. Multiple hair epithelioma is mostly associated with hereditary factors. It is more likely to occur on both sides of the nasolabial groove, the size of the papular nodules, and the diameter of 0.2-0.5cm. It must be confirmed by family history and histopathological examination. They can be treated with laser and surgery.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.5

【相似文献】