Heller Debra S, Haefner Hope K, Hameed Meera, Lieberman Richard W
Departments of Pathology and Laboratory Medicine and of Obstetrics, Gynecology and Women's Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA.
J Reprod Med. 2002 Sep;47(9):695-700.
To evaluate the pathology of vulvar hidradenitis suppurativa (HS).
A retrospective review of the histology of resections for vulvar HS was performed, and a battery of immunohistochemical stains was performed. They included markers of apocrine differentiation (GCDFP-15, CD15, lysozyme) and eccrine differentiation (GCDFP-15, S-100, CA-19.9, HMB45).
Thirteen cases were available for review. Eccrine glands accounted for the majority of glands in all cases. Apocrine glands were not seen or were present only away from the area of active inflammation in 10 cases. In two cases, glands were totally destroyed in the areas of inflammation. Evidence of follicular obstruction was present in 11 of 13 cases. Severity of inflammation was variable, ranging from minimal, with burned-out disease, to severe. Fibrosis was variable but was greater with less inflammation, suggesting a later stage in disease evolution. Inflammation of the glands was often absent or minimal and seen only with associated poral occlusion. GCDFP-15 stained both apocrine and eccrine glands (only the dark cells). S-100 stained only the secretory (clear) cells of the eccrine glands. CD15 stained apocrine glands. Lysozyme stained apocrine glands, but this was not a consistent finding. CA19-9 gave inconsistent results in eccrine glands. HMB-45 was negative in all cases.
Cases of vulvar HS showed a majority of eccrine glands in active areas. Apocrine glands, when present, were away from active inflammation. Inflammation and eventual destruction of glands appear to be a secondary part of the disease process. GCDFP-15 is a reliable marker for both apocrine differentiation and the dark cells of eccrine glands. S-100 is a reliable marker for the clear cells of eccrine glands. CD15 also was reliable for apocrine differentiation. Lysozyme showed weak apocrine staining. CA19-9 and HMB-45 were not reliable markers for apocrine or eccrine gland differentiation.
评估化脓性汗腺炎（HS）的病理学特征。
对外阴HS切除术的组织学进行回顾性分析，并进行一系列免疫组化染色。这些染色包括顶泌汗腺分化标志物（GCDFP - 15、CD15、溶菌酶）和小汗腺分化标志物（GCDFP - 15、S - 100、CA - 19.9、HMB45）。
13例可供分析。所有病例中小汗腺占腺体的大多数。10例未见顶泌汗腺，或仅在远离活动性炎症区域存在顶泌汗腺。2例中，炎症区域的腺体完全被破坏。13例中有11例存在毛囊阻塞的证据。炎症严重程度各不相同，从轻微的、病情消退的，到严重的。纤维化程度各异，但炎症较轻时纤维化更明显，提示疾病发展的后期阶段。腺体炎症通常不存在或很轻微，仅在伴有导管阻塞时可见。GCDFP - 15可同时标记顶泌汗腺和小汗腺（仅深色细胞）。S - 100仅标记小汗腺的分泌（透明）细胞。CD15标记顶泌汗腺。溶菌酶标记顶泌汗腺，但结果不一致。CA19 - 9在小汗腺中的结果不一致。所有病例中HMB - 45均为阴性。
外阴HS病例中，活跃区域的腺体多数为小汗腺。顶泌汗腺若存在，则远离活动性炎症。腺体的炎症和最终破坏似乎是疾病过程的次要部分。GCDFP - 15是顶泌汗腺分化和小汗腺深色细胞的可靠标志物。S - 100是小汗腺透明细胞的可靠标志物。CD15对顶泌汗腺分化也可靠。溶菌酶显示顶泌汗腺染色较弱。CA19 - 和HMB - 45不是顶泌汗腺或小汗腺分化的可靠标志物。
