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血管附属器偏心性痣。

Angioadnexocentric nevus.

机构信息

Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan, USA.

出版信息

J Dermatol. 2012 Nov;39(11):909-15. doi: 10.1111/j.1346-8138.2012.01599.x. Epub 2012 Jul 4.

Abstract

An association of melanocytic nevus with eccrine glands has been well-documented and well-known as eccrine-centered nevus. Non-giant congenital nevi sometimes contain angiocentric and/or adnexocentric growth of nevus cells. Blood vessels are the most prominent site of nevus cell infiltration and propagation. In our specimen, the second was eccrine ducts. These selective sites of infiltration gave rise to a linear pattern of nevus cell distribution. Upon cursory examination at low magnification, vascular pathologies such as lymphocytic perivasculitis and particularly "coat-sleeve-like" pattern of erythema annulare centrifugum were suggested. S-100 immunostained perivascular and periductal lymphocytoid cells while CD3, 4 and 8 for T cells, and CD20 and 79a for B cells, were all negative. S-100 detected some invasive behavior of nevus cells penetrating into the vascular and ductal walls. However, Ki-67 was negative in all cells, suggesting a benign nature of this lesion. It is postulated that intradermal nevus cells of fetal skin freely migrate through mesenchymal tissue and stop when they hit barriers such as blood vessels and eccrine ducts and propagate in situ. How does this random migration theory explain the blood vessels and eccrine ducts getting the largest share of nevus cells? It is because they are the largest barriers of fetal dermis.

摘要

黑素细胞痣与小汗腺的关联已被充分记录和认识,被称为小汗腺中心性痣。非巨大先天性痣有时包含血管中心性和/或附属器中心性的痣细胞生长。血管是痣细胞浸润和增殖的最突出部位。在我们的标本中,第二个是小汗腺导管。这些选择性的浸润部位导致了痣细胞呈线性分布。在低倍镜下粗略检查时,提示存在血管病变,如淋巴细胞血管周围炎,特别是红斑性环状离心性的“套袖样”模式。S-100 免疫染色显示血管周围和导管周围淋巴样细胞,而 CD3、4 和 8 用于 T 细胞,CD20 和 79a 用于 B 细胞,均为阴性。S-100 检测到一些痣细胞侵入血管和导管壁的侵袭性行为。然而,所有细胞的 Ki-67 均为阴性,提示该病变为良性。据推测,胎儿皮肤的真皮内痣细胞可自由通过间充质组织迁移,并在遇到血管和小汗腺等屏障时停止,并在原位增殖。这种随机迁移理论如何解释血管和小汗腺获得最多的痣细胞?这是因为它们是胎儿真皮中最大的屏障。

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