Peters M S, Su W P
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Dermatol Clin. 1992 Jan;10(1):37-57.
An accurate assessment of subcutaneous lesions can be made by joining the differential diagnoses generated by clinical and histologic features. Anatomic location of lesions, presence or absence of ulceration, occurrence of lipoatrophy, history of trauma, association with immunologic or metabolic disorders, and age of the patient are important clinical data to consider in conjunction with the microscopic features. Individual histologic features such as calcification, cytophagic histiocytes, pseudocysts, lymphoid nodules, and crystals should be evaluated in conjunction with the inflammatory infiltrate (i.e., granulomatous, neutrophilic, lymphocytic, or combined); presence and type of necrosis (e.g., basophilic, hyaline, lobular, or septal); and presence and extent of sclerosis. For optimal management of patients, it is important to consider the differential diagnosis generated by the dominant histologic features as well as the clinical and histologic abnormalities.
通过结合临床和组织学特征所产生的鉴别诊断结果,能够对皮下病变做出准确评估。病变的解剖位置、有无溃疡、脂肪萎缩的发生情况、创伤史、与免疫或代谢紊乱的关联以及患者年龄,都是需要结合微观特征加以考虑的重要临床数据。诸如钙化、噬细胞性组织细胞、假囊肿、淋巴小结和晶体等个体组织学特征,应结合炎性浸润(即肉芽肿性、嗜中性、淋巴细胞性或混合性)进行评估;坏死的存在情况和类型(例如嗜碱性、透明样、小叶性或间隔性);以及硬化的存在情况和范围。为了对患者进行最佳管理,重要的是要考虑由主要组织学特征以及临床和组织学异常所产生的鉴别诊断结果。