Kapadia S B, Heffner D K
Department of Otolaryngic and Endocrine Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Eur Arch Otorhinolaryngol. 1992;249(4):195-200. doi: 10.1007/BF00178468.
The term pyogenic granuloma (PG) is a misnomer. The histopathologic appearance is fairly characteristic, the lesion being in fact a lobular capillary hemangioma. The recognition of PG as a clinically polypoid or exophytic, circumscribed lesion is of importance to both the clinician and the pathologist, as this feature distinguishes PG from most malignant vascular tumors. Although PG may be multiple, especially on the skin, and necrosis is not uncommon, invasion of adjacent structures is not seen. Diagnostic pitfalls occur histologically when the characteristic lobular configuration of PG is not recognized because of a solid growth pattern of endothelial proliferation, the presence of brisk mitosis, intervascular stromal fibrosis or spindle cell proliferation, and occasionally an epithelioid appearance of endothelial cells. The different vascular neoplasms that may be confused with PG are discussed, and the clinical and histopathologic features of PG are emphasized.
脓性肉芽肿（PG）这一术语是用词不当。其组织病理学表现颇具特征，实际上该病变是一种小叶状毛细血管瘤。认识到PG是临床上呈息肉样或外生性、界限清楚的病变，对临床医生和病理学家都很重要，因为这一特征可将PG与大多数恶性血管肿瘤区分开来。尽管PG可能是多发的，尤其是在皮肤上，且坏死并不少见，但未见侵犯相邻结构的情况。当由于内皮细胞增殖呈实性生长模式、存在活跃的有丝分裂、血管间间质纤维化或梭形细胞增殖，以及偶尔内皮细胞呈上皮样外观而未识别出PG特征性的小叶结构时，就会在组织学上出现诊断陷阱。本文讨论了可能与PG混淆的不同血管肿瘤，并强调了PG的临床和组织病理学特征。
