Ofaiche J, Chauvel A, Cogrel O
Service de dermatologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
Service d'anatomo-pathologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
Ann Dermatol Venereol. 2014 Oct;141(10):607-10. doi: 10.1016/j.annder.2014.06.017. Epub 2014 Aug 5.
Glomangiomas are benign vascular tumours. They are usually multiple, painless and extradigital. Herein we report a case of a solitary subungual glomangioma.
This 65-year-old woman presented with a history of bluish, asymptomatic, subungual lesions located in the lunula of her right thumb. Surgical exploration by a transungual approach showed a large bluish, well-circumscribed tumour, which was completely excised. Histological examination revealed numerous dilated blood vessels surrounded by aggregates of glomus cells, which was consistent with the diagnosis of glomangioma.
Glomus tumours are benign tumours arising from glomus cells. Histopathologically, based on the predominant tissue type present, glomus tumours are classified as solid glomus tumours, glomangiomas or glomangiomyomas. The classical form usually consists of a painful erythematous nodule with exaggerated sensitivity to cold and pressure. The nails are frequently involved, with two sites of predilection: the matrix and the nail bed. Vascular forms of glomus tumours or glomangiomas have a different clinical presentation and are usually multifocal, bluish, painless and extradigital. Diagnosis is frequently based on histological examination. Our observation raises the question of differential diagnosis with regard to matrix melanocytic tumours (blue nevi or melanomas).
We report the case of a solitary subungual glomangioma. Histological examination is necessary to rule out a clinically indistinguishable benign or malignant melanocytic tumour.
血管球瘤是良性血管肿瘤。它们通常为多发,无痛且位于手指外。在此我们报告一例孤立性甲下血管球瘤。
这位65岁女性有位于右手拇指甲半月处的蓝色无症状甲下病变病史。经甲入路手术探查显示一个大的蓝色、边界清晰的肿瘤,将其完整切除。组织学检查显示大量扩张的血管被血管球细胞聚集物包围,符合血管球瘤的诊断。
血管球瘤是起源于血管球细胞的良性肿瘤。在组织病理学上,根据主要存在的组织类型,血管球瘤分为实性血管球瘤、血管球瘤或血管球肌瘤。经典形式通常由对冷和压力敏感增强的疼痛性红斑结节组成。指甲常受累,有两个好发部位:甲母质和甲床。血管球瘤或血管球瘤的血管型有不同的临床表现,通常为多灶性、蓝色、无痛且位于手指外。诊断通常基于组织学检查。我们的观察提出了与甲母质黑素细胞肿瘤(蓝痣或黑色素瘤)鉴别诊断的问题。
我们报告了一例孤立性甲下血管球瘤。组织学检查对于排除临床上难以区分的良性或恶性黑素细胞肿瘤是必要的。