Ishikawa Martin K, Arps David P, Chow Conroy, Hocker Thomas L, Fullen Douglas R
Department of Pathology, University of Michigan, Ann Arbor, MI, USA.
Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.
Histopathology. 2015 Dec;67(6):836-42. doi: 10.1111/his.12716. Epub 2015 Jun 4.
Classic histopathological features of molluscum contagiosum (MC) include a crateriform, acanthotic epidermis containing intracytoplasmic molluscum bodies (MBs). In our experience, a subset of cases lack these features on initial haematoxylin and eosin-stained sections. We aimed to describe the histopathological features of MC other than those classically described.
Sixty-seven biopsies diagnosed as MC from January 2011 to October 2012 were retrospectively reviewed. Keratinocytes peripheral to the diagnostic cells with MBs had prominent nucleoli (67; 100%), amphophilic cytoplasm (54; 81%), and in many instances clear cytoplasmic vacuolization (38; 57%). Stroma surrounding MC lesions showed fibroedematous to fibromyxoid changes in many cases (36; 54%), with a subset (13; 19%) showing abundant dermal mucin. In eight of 67 cases (12%), initial sections did not possess MBs or crateriform epidermis of MC. In these cases, initial sections revealed only the epithelial and/or perilesional stromal changes described above. Additional sections contained MBs in all of these cases.
Perilesional fibroedematous to fibromyxoid stroma and keratinocyte changes, including prominent nucleoli and amphophilic cytoplasm with clear vacuolization, are common in MC. Recognizing these features may prove helpful in reaching the diagnosis of MC in cases lacking classic histopathological features on initial sections.
传染性软疣（MC）的经典组织病理学特征包括呈火山口状、棘层肥厚的表皮，其中含有胞质内软疣小体（MBs）。根据我们的经验，一部分病例在最初的苏木精和伊红染色切片上缺乏这些特征。我们旨在描述MC除经典描述特征之外的组织病理学特征。
对2011年1月至2012年10月诊断为MC的67例活检标本进行回顾性分析。具有MBs的诊断性细胞周围的角质形成细胞有明显的核仁（67例；100%）、嗜双色性细胞质（54例；81%），且在许多情况下有明显的胞质空泡化（38例；57%）。MC病变周围的基质在许多病例中显示出纤维水肿至纤维黏液样改变（36例；54%），其中一部分（13例；19%）显示真皮黏液丰富。在67例病例中的8例（12%），最初的切片没有MC的MBs或火山口状表皮。在这些病例中，最初的切片仅显示上述上皮和/或病变周围基质的改变。所有这些病例的额外切片中均含有MBs。
病变周围纤维水肿至纤维黏液样基质以及角质形成细胞改变，包括明显的核仁、嗜双色性细胞质和明显的空泡化，在MC中很常见。认识到这些特征可能有助于在最初切片缺乏经典组织病理学特征的病例中做出MC的诊断。
