Hu Sindy, Kuo Tseng-tong, Hong Hong-Shang
Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Am J Dermatopathol. 2002 Dec;24(6):490-2. doi: 10.1097/00000372-200212000-00006.
Mast cells with bilobed or multilobed nuclei have only rarely been observed in the bone marrow of patients with systemic mastocytosis and in a case of subdural mast cell sarcoma. To our knowledge, they have not been reported in cutaneous mast cell disease. We report a rare occurrence of mast cells with bilobed or multilobed nuclei (atypical mast cell type II) in a nodular lesion of a 24-year-old woman with urticaria pigmentosa. The typical and atypical mast cells were confirmed by Giemsa and Leder's naphthol-AS-D-chloroacetate esterase stains and by immunohistochemical staining for tryptase and KIT protein (CD117). Although the nodular lesion with atypical mast cells did not appear to be cytologically malignant, the occurrence of atypical mast cells in a nodular lesion but not in a papular lesion might denote progression of the disease as suggested by the emergence of cells positive for p53.
在系统性肥大细胞增多症患者的骨髓以及1例硬脑膜下肥大细胞肉瘤病例中，仅偶尔观察到具有双叶或多叶核的肥大细胞。据我们所知，在皮肤肥大细胞疾病中尚未有此类报道。我们报告了1例24岁患色素性荨麻疹女性的结节性病变中罕见出现的具有双叶或多叶核的肥大细胞（非典型II型肥大细胞）。通过吉姆萨染色、莱德萘酚-AS-D-氯乙酸酯酶染色以及对类胰蛋白酶和KIT蛋白（CD117）进行免疫组化染色，证实了典型和非典型肥大细胞。尽管含有非典型肥大细胞的结节性病变在细胞学上似乎并非恶性，但结节性病变而非丘疹性病变中出现非典型肥大细胞，可能如p53阳性细胞的出现所提示的那样，表明疾病进展。
